Some facts: No caregiver wants his or her patient to die needlessly. Sudden cardiac death remains the number one killer of humans. The arrhythmia that causes sudden death occurs unpredictably. One minute you are fine and the next you are–in the absence of a shock–dead. When cardiac arrest occurs outside a hospital, or say, a fire station, the chance of survival is dismal; there are few Mulligans. Although the majority of people who suffer cardiac arrest have no known heart disease, the presence of heart disease increases the risk of cardiac arrest.
Despite years and years of research, we still are not much closer to knocking heart disease down the list of top killers. The tools we have at our disposal for treating cardiac arrest are blunt instruments. The internal cardiac defibrillator is one such big hammer. Yes, an ICD is an imperfect device, but at least it has one big thing in its favor: Science. We know, with about as much certainty as possible these days, that carefully selected well-informed patients glean a small survival advantage from the protective device.
Here’s the rub though: There are also patients with significant heart disease and an increased risk for sudden death who do not qualify for an ICD. Maybe they have a transient problem that will resolve; maybe their diagnosis is too new, maybe their previous ICD was removed because of infection and now are awaiting a new one. There are other reasons too. The point is that some patients have a high risk of cardiac arrest and cannot have an ICD. What should we recommend for these fellow humans?
One option that has come available is the wearable cardiac defibrillator (WCD). Zoll corporation is the single manufacturer. They call the beeping vibrating shocking garment, the LifeVest. It’s been approved for use in the US for more than a decade. Yet, not one clinical trial has ever been completed to confirm that shackling another human to a beeping vibrating shocking device is beneficial. The use of this well-reimbursed device has soared of late.
As a topic to debate, the LifeVest is perfect. The essence really is how much should we bubble-wrap Life?
I hope you want to read more. It took me about 3 months to get my thoughts on this shocking topic (grin) down to 1200 words.