Towards the end of February 2024 I suffered heart failure. Thanks to the Paramedics and the wonderful team at my local A&E department I survived. I was then transferred to a Specialist unit who continued to provide excellent level of care. After a few weeks I was afforded the opportunity to consider the short term use of a ZLV.
Living with ZLV
My focus is primarily on providing a pragmatic perspective on living with a ZLV . I will endeavour to cover “ everything “ from the technology - going to the loo and everything in between I will provide a summary on my thoughts and hopefully someone somewhere may find the review helpful . I lived at home with the ZLV for 4 weeks
ZLV USER EXPERIENCE
For me the “elephant “ in the room has been the weight of the transmitter and battery pack, at half-a-kilo I found it too heavy. ( pulling on my shoulder muscles increased discomfort and pain )
The belt loop is sturdy but ineffective as clipping this’s to my belt resulted in my jeans almost falling down ! The strap is adjustable so you may carry the transmitter pack across your shoulder. However, it is badly thought out. The strap is very narrow made with a hard nylon. I found it uncomfortable to wear “digging” into my shoulder
The weight, strap and design of the ZLV makes basic functions difficult to do. Going to the loo was challenging and not hygienic. Remember you wear the ZLV 24/7 . Cooking, making a “brew” is also difficult as the ZLV gets in the way and consequently could contribute to an accident.
After a couple of days removing and changing the ZLV becomes second nature. Following the numbering guide works. However putting on the ZLV alone is very, very challenging. The recommended use of a mirror to help position the ZLV (back) I found impossible and was fortunate that my wife was always available to help in this regard. Couple of other points. Ensure that each sensor is fully placed over the Velcro if not it will irritate your skin. I have experienced rashes, bleeding and bruising
Clean the sensors regularly with the solution a provided as this helps ensuring connectivity
GOING OUT
I did venture out a few times and my ZLV came with me. Now I have mentioned the strap and belt loop already and how restrictive I found both. For me I simply carried the transmitter/ battery in one of my hands. Not ideal but it kind of worked for me so I was able to get some exercise - short walks on my short walks.
CONCLUSION
Frustrations aside , the ZLV served its purpose and for me the right decision was made to take the ZLV home. What would not work is having to put up with the ZLV for a longer period of time. I say this as the frustrations and concerns mentioned would outweigh the benefit of being home and would have a negative impact on my physical and mental wellbeing.
MAKING THE EXPERIENCE BETTER FOR THE PATIENT AND CARER AND INCREASING ADOPTION RATES
Carer needs to be part of the process (NHS)
“What if”;and “contact” guides should the ZLV be activated (NHS & ZOLL)
Significantly reduce weight of transmitter/battery pack (Zoll)
Make carry strap wider and use softer materials making it comfortable to wear e.g. neoprene , used in photography (Zoll)
Redesign of wiring and velcro pads which connects the sensors . Too much wiring results in making ZLV uncomfortable and irritating causing pressure points - skin rashes which did cause bleeding (Zoll)
ZLV material does not let your skin pin “breath” and as such contributes to aforementioned issues. Zoll could look at material used in sports wear and consider adoption of products like “wicking) ( ZOLL)
After 4 weeks of daily use the “pads” and “sensors” look “tired” and fragile. Consideration to be given in providing patient with a sealed spare set of a “pad and sensor” which are ready to be used if required. Zoll offer a 24*7 support service for replacements but given the ZLV is a CRITICAL LIFE support device it is questionable if such a service will be available at weekend and bank holidays.
There is no structured patient support. I left hospital with the ZLV and that was it. Formalised patient support must be put in place before sending the patient home. It’s worth highlighting that in the UK the ZLV is new and with low patient adoption . Awareness amongst the NHS community is equally low. Having a formalised structure in place will provide patient and carer reassurance and help with mental wellbeing.
Proactive call to be made every 3-4 days to address concerns, talk through “readings” provide reassurance etc. Failure to do so is adding to stress levels and potentially having a negative impact on health . (Zoll and or NHS)
Marketing collateral is misleading and too US focused needs resigned to address UK market (ZOLL)
The ZLV manual appears to have been written as a “technical “ guide and is too long and over complicated. Consider a re-write from a patient perspective, more concise, appropriate language patterns (ZOLL)
Great post, very interesting m you should send it through to the hospital and Zoe to see if they will make your sensible improvements.It sounds very similar to wearing a Holter kit , which many of us know are frustrating enough as it is just to wear for a week.
I'm surprised they don't give you spares to replace sensors etc.
With the NHS Holter kits I always get numerous spares as if the things get worn or tired they are not as accurate in getting results.
Thank you for your response very much appreciated. I have shared the post with my MHS team and had a conversation with them. I have also offered to go on a Zoom call or similar if that will help. I will leave it to the NHS team to reach out to Zoll whilst I focus on my recovery. Thanks again and if I hear any more I will share , have a splendid weekend
This is a really interesting read and I completely agree with all of this. I'm glad your 4 weeks with the vest is over now and I hope you're doing OK? I was expected to wear my life vest for 3+ months (depending on if there was improvement after the 3 month review) but as I've mentioned before, I only wore it for a few weeks before I found it unbearable and impacting on my mental health considerably.
I also experienced painful rashes where the sensors were and also on my shoulder from the weight of the battery making the strap dig in.
It's tricky, because when you are in the unfortunate position where one of these is required, you are just grateful something like this exists to get you out of hospital and back home. But you also feel vulnerable and low and I found having to haul this vest around even more upsetting for me.
I really hope our feedback is being listened to by Zoll and the cardiologists recommending the vest, so that improvements can be made. It really is great that something like that exists, but it really does need improvements.
Thank you so much for you kind feedback. I can completely understand how you feel . The reaearch in the links I attached vindicates your comments and in fact peoples mental wellbeing is a significant issue for patients. I was lucky to get a time bound agreement and it was stuck to. I have offered to attend a Zoom call with the NHS team and Zoll to help further but I am not chasing as I need to recover from the ICD surgery. Zoll are simply selling the ZLV into the NHS, they know all about the challenges the NHS has and their product could help. However the cost to the NHS per month for a patient using a Zoll Life Vest is circa £4000 so it’s not cheap or cost effective if the patient is not using the Vest. I am not sure where you are in the UK but for sure I would push back. The NHS is doing the right thing by trying the Zoll Life Vest but it has to be right for the patient (one size does not fit all) And the NHS need to be more demanding of Zoll and push for changes to the product. It’s frustrating as Zoll have little competition therefore little incentive to a change anything.
To be honest my wife has been a lobbyist pushing for improvements in technology used for T1 diabetics so I had someone at home encouraging me to do similar. If I hear anymore I will,send another post.
As for my health, I hopefully will recover sufficiently to start a new normalised life .
I hope you find a way forward which will have a positive impact on yourself,. In the meantime have a peaceful weekend
My 6 month experience with a Life Vest was not bad, to be honest. I immediately sussed out that the shoulder strap was going to be uncomfortable, so I bought a cheap waist pack and put the main unit in there. Much more comfortable and took the weight off my shoulders.
Also, I had several fabric vests, and the key is to wash them every 2 days (every day if you sweat).
I also made sure to moisturize my skin and shower daily, so it didn't get irritated.
Other points: I cleaned the contacts and wires religiously with alcohol to kill any bacteria that might create irritation. It can be a little bit fussy to get everything situated right, or it will buzz disconcertingly.
On the other hand, how great is it to have a defibrillator right on you? Medical technology is amazing.
I also found Zoll's customer support to be OK, but with the caveat that you call them in the U.S. (agree that their UK/Europe network is not well developed yet.) The US reps are cheerful and competent, even it if did cost me a little bit (using Viber) for an internet call.
I did have to go online to some US forums to figure out the SOPs for the Life Vest. There are a few tricks and tips that make using it relatively intuitive. On the other hand, I had 6 months to get to know it, including 6 weeks mostly in bed!
After 6 months it was determined that I didn't need an implanted defibrillator, as the Life Vest was never triggered by a heart problem.
It is true that the design hasn't changed much in about 15 years but I suspect it's probably a case of not fixing something that isn't broken. It has to be very durable and reliable so I doubt you could miniaturize the components.
thank you for you comments. My objective with my post was to act as an agent of change. The strap, weight can be addressed by Zoll the manufacturer and seller of the ZLV into the NHS. I appreciate people making advice changes . I change my ZLV every day, washing the one worn and sensors were cleaned every day. Now it was not the height of summer that I was wearing the ZLV but it still made me sweat hence my point with material. The design a hasn’t changed not because it ain’t broke but in my view is there is lack of competition. Kindly look at the reaseaach which identifies many reasons for low take up . As for technology, my question to Zoll is that other health related products have changed their design significantly over the last 3-5 years. If I look at one area which is diabetes, particularly for type 1, the transformation of components, has significantly improved how people with type 1 diabetes can manage their condition more effectively with confidence and improved quality of life. One of the reasons is competition from providers and market opportunities.. So after 15 years ( more 20 I think) I would suggest there has been technology changes in batteries, sensors, pads and overall design which could be. Used to make the patient experience better. One example I remember was sending data from the Zoll and the insistence that a modem was to be used if you had no wifi when I had one night in hospital with the ZLV , Classic example, of lack of knowledge and that compatibility. If Zoll and the NHS want to increase adoption they need to do something different, doing the same with the same product expecting a different outcome is madness
Agree about the lack of competition. I actually wondered why there isn't really any. Maybe Zoll have some ironclad patents. Also, most don't wear them very long (I was unusual), so I suspect it's a case of "good enough is good enough" if they fulfill their primary function.
On another note, my wife and I are considering getting a defibrillator for our house. There are a number of services that will rent them by the month. I've asked my accountant about charging it as a business expense since I work from home...so far, no luck!
Good to back from you. I suspect using the ZLV for the time you did it became more acceptable and the phrase “puppy dog marketing (syndrome) sprang to my mind. Anyway if it worked for you that’s all that matters. Best of luck moving forward,, be interesting to see where Zoll goes with their products
thank you for this review and for the way this prompts further comments from other users
i am a member of another online group for people who have had a Takotsubo episode - that is an international group and only USA members report being expected to wear a "life vest" afte heir discharge from hospital - so other members are left wondering why they don't get them
no members there have yet given such a thorough report, limiting themselves to comments about the reassurance it provides compared to the inconveniences, particulary during hot weather
the NHS have no approved these for use for Takotsubo (yet) and, from your report, i gather that they are trying them out for some conditions - i am sure they will apply their usual caution to issueing them!
Hi , thank you for your comments. Hopefully if patients can work as a collective we can help influence positive change. Idealistic I guess but if we do nothing, nothing will happen. And here’s the irony, if Vest manufacturers listen and adopt then they are likely to “sell more”, user adoption will increase as will the revenues/profits of manufacturers and here in the UK we will be able to address our chronic waiting lists , thanks again
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