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Cardioverter defibrillator vest may be viable alternative to pediatric implants

by John R. Fischer, Senior Reporter | July 03, 2018
Cardiology
Wearable defibrillators may be an effective
and safe alternative for children with
arrhythmias who are not suitable
for implants
Children unable to undergo cardiac implants for heart arrhythmias may be able to wear a vest instead.

That vest in question is a wearable cardioverter defibrillator which may be a safe and effective alternative for children with ventricular heart rhythm disorders that pose the risk of sudden cardiac arrests or deaths, according to researchers in the largest U.S. pediatric study to date.

“Our results, which stem from the largest study to date among children in the United States using wearable cardioverter defibrillators, suggest that these external devices can help save the lives of children who are, at the time, not good candidates for surgically implanted defibrillators because of their medical condition,” said the study’s principal investigator David Spar, assistant professor of pediatrics at the University of Cincinnati and a pediatric electrophysiologist at Cincinnati Children’s Hospital, in a statement.

Surgically implanted cardioverter defibrillators are the main choice of treatment for children with arrhythmias, but may not be a good option in children who require only a temporary “bridge” to help their heart. Such procedures also involve invasive surgery or prolonged hospitalization.

Though approved for use in pediatric patients in 2015 by the FDA, research on the effective and safe use of wearable cardioverter defibrillators is limited, creating a lack of understanding and hesitancy in providing it to children with dangerous arrhythmias.

Researchers tested these aspects on eight out of 455 patients whose average age was 15. All eight received at least one shock treatment to interrupt dangerous heart rhythms.

Six benefited from the therapy with the device detecting and stopping their condition. The device misread a signal in two of the patients; though misfiring in all cases, dangerous heart rhythm was successfully interrupted, enabling normal heart rhythm to return and the patient to survive.

The findings are the first to describe appropriate therapy with a wearable cardioverter defibrillator for children, and indicate that such devices could offer protection for arrhythmias without prolonged hospitalization.

The results are based on a review of clinical outcomes among all U.S. pediatric patients who wore cardioverter defibrillators between 2009 and 2016.

Coauthors on the study were Nicole Bianco, Ph.D.; Timothy Knilans, M.D.; Richard, Czosek, M.D.;and Jeffrey Anderson, M.D.

No outside sources were used for funding.

The findings were published in Circulation: Arrhythmia and Electrophysiology, an American Heart Association journal.

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