Their design changes, the students say, should help persuade patients at risk for sudden cardiac arrest to wear the system around the clock.
"In two studies, up to 20 percent of patients who received the defibrillator garment that's already available did not keep it on all the time because of comfort and appearance issues, problems sleeping in it, and frequent 'maintenance alarms,' which occur when the device does not get a good signal from sensors on the patient's skin," said
Wearable defibrillators, resting against the skin, are designed to detect arrhythmia, an irregular heart rhythm that can cause death in minutes if it is not stopped by controlled jolts of electricity. People who face this higher risk of sudden cardiac arrest include patients who have undergone open-heart surgery and those who have recently survived a heart attack.
The long-term treatment for such patients is to surgically implant a small defibrillator in the chest, similar to a pacemaker. However, the students said, such operations cost roughly
The defibrillator project was sponsored and mentored by
"Our JHU design team students were able to survey electrophysiologists and their patients who wore the currently approved wearable cardioverter defibrillator," Cohen said. "The students' research confirmed my personal findings, namely that the current device has several components that could be improved. The students took this information and with my guidance designed a better mousetrap. The new device incorporates features that should improve patient compliance, ease of use and overall functionality."
In particular, the student replaced the existing chest harness-style garment with a more comfortable vest-like design made of thin, breathable and stretchable fabric, which also is waterproof for easy cleaning. The shirt can be worn unobtrusively beneath the patient's clothing. Its electrical components, capable of delivering a 200-joule shock to stop a deadly arrhythmia, are encased in thin pockets on the sides of the garment. The students also replaced a bulky control box hanging from the patient's waist with a smaller wireless system worn like a watch on the patient's wrist. This controller gives the wearer a 30-second warning to stop an impending shock if the system has been activated by a false alarm.
"We did not change any of the science involving how a wearable defibrillator works," said team member
The students' prototype has already garnered some attention. It recently won a
In May, the student inventors showcased their device at the annual Johns Hopkins Biomedical Engineering Design Day event, organized by the university's
The students' have completed preliminary testing at the Johns Hopkins Hospital Simulation Center, using manikins wired to mimic heart patients. The team has obtained a provisional patent covering some of their innovations. Team members plan to continue to refine the prototype and to confer with medical device makers about advancing the project.
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