Use of a wearable automated defibrillator in children compared to young adults

A wearable automated external defibrillator has been shown to be efficacious in the prevention of sudden death in adults who had a history of cardiac arrest but who did not have a permanent internal cardioverter/defibrillator (ICD) placed. The use of a wearable defibrillator has not been established in the pediatric population.

We retrospectively reviewed the clinical database for the wearable external defibrillator from ZOLL Lifecor Corporation (Pittsburgh, PA, USA). We compared the use of the wearable defibrillator in patients ≤18 years of age to those aged 19-21 years.

There were 81 patients ≤18 years of age (median age = 16.5 years [9-18] and 52% male). There were 103 patients aged 19-21 years (median age = 20 years [19-21] and 47% male). There was no difference between groups in average hours/day or in total number of days the patients wore the defibrillator. In patients ≤18 years of age, there was one inappropriate therapy and one withholding of therapy due to a device-device interaction. In patients aged 19-21 years, there were five appropriate discharges in two patients and one inappropriate discharge in a single patient.

It is reasonable to consider the wearable automated external defibrillator as a therapy for pediatric patients who are at high risk of sudden cardiac arrest but who have contraindications to or would like to defer placement of a permanent ICD. As there were no appropriate shocks in our patients ≤18 years of age, this study cannot address efficacy of the therapy.