Wearable Cardiac Defibrillator

Refused to Remove Vest • Xray of the Week

This patient refused to remove his vest prior to getting a chest X-ray. The concerned tech called the radiologist. Fortunately, the radiologist knew that the radiopaque objects were due to the LifeVest wearable defibrillator made by Zoll which is a treatment option for sudden cardiac arrest. Unlike an implantable cardioverter defibrillator (ICD), the LifeVest is worn outside the body rather than implanted in the chest.

This device continuously monitors the patient's heart with dry, non-adhesive sensing electrodes to detect life-threatening arrhythmias. If a life-threatening rhythm is detected, the device alerts the patient prior to delivering a treatment shock, and thus allows a conscious patient to delay the treatment shock. If the patient becomes unconscious, the device releases a Blue™ gel over the therapy electrodes and delivers an electrical shock to restore normal rhythm.

Chest Xray of a patient wearing the Zoll LifeVest. We have seen this device used increasingly while patients are waiting for their ICD placement.

Dr. Kamran Toluie, a cardiologist in Beverly Hills, California describes how the LifeVest can be used as a temporary potentially life-saving measure in patients with cardiomyopathy who may respond to conservative medical management before an ICD is needed.

Illustration of the Zoll LifeVest and how it looks on a patient.

(from http://lifevest.zoll.com)

Video of the Zoll LifeVest and how it works.

References:

1. Adler A, Halkin A, Viskin S. Wearable cardioverter-defibrillators. Circulation. 2013;127 (7): 854-60.

2. Chung MK, Szymkiewicz SJ, Shao M, et al. Aggregate national experience with the wearable cardioverter-defibrillator: event rates, compliance, and survival. J Am Coll Cardiol. 2010;56:194–203.

3. Zoll LifeVest Online Information for Medical Professionals. http://lifevest.zoll.com/medical-professionals

Kevin M. Rice, MD is the president of Global Radiology CME

Dr. Rice serves as the Chair of the Radiology Department of Valley Presbyterian Hospital in Los Angeles, California and is a radiologist with Renaissance Imaging Medical Associates. Dr. Rice has made several media appearances as part of his ongoing commitment to public education. Dr. Rice's passion for state of the art radiology and teaching includes acting as a guest lecturer at UCLA. In 2015 Dr. Rice founded Global Radiology CME to provide innovative radiology education at exciting international destinations, with the world's foremost authorities in their field. In 2016, Dr. Rice was nominated and became a semifinalist for a "Minnie" award for the Most Effective Radiology Educator.

Follow Dr. Rice on Twitter @KevinRiceMD

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