Its in-game ability allows Nefeltari Vivi to draw a card and give a Character the Rush keyword which allows it to attack on the turn it was played
There are also commanders that exploit life loss, with Ob Nixilis, Captive Kingpin, Valgavoth, Harrower of Souls, and Rakdos, Lord of Riots (its a very Rakdos-coded mechanic)
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Cards that excel in this quadrant are often prohibitively expensive to cast (see: In Garruk's Wake), and when they aren't, they are early picks
They'll buy you time and maybe help you live for another turn, but they rarely impact the board or stop someone from making the same lethal attack the following turn