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Cardiomyopathy and the use of implanted cardio-defibrillators in children
S J Kaminer1, A S Pickoff, A Dunnigan
1Department of Pediatrics, University of Miami School of Medicine, Florida 33101.
Insights
Automatic implantable cardioverter-defibrillators (ICDs) show promise for improving survival in children with cardiomyopathy and ventricular dysrhythmias. This technology offers a new treatment avenue for young patients facing poor prognoses.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
Background:
- Cardiomyopathy and ventricular dysrhythmias carry a poor prognosis in children and adults.
- Medical therapy alone offers limited survival benefits for these patients.
Observation:
- Automatic implantable cardioverter-defibrillators (ICDs) have improved survival in adults with refractory ventricular dysrhythmias.
- Limited use of ICDs in children was due to device size and lack of programmability.
Findings:
- This study presents four pediatric cases of cardiomyopathy with refractory ventricular dysrhythmias managed by ICDs.
- Two patients were the youngest and smallest recipients, with one receiving a programmable model.
Implications:
- ICD implantation may enhance survival in carefully selected pediatric patients with cardiomyopathy and ventricular dysrhythmias.
- The use of programmable ICDs in children represents a significant advancement in managing these high-risk conditions.
Abstract:
Children and adults with cardiomyopathy and ventricular dysrhythmias have a uniformly poor prognosis, despite medical therapy. The use of automatic implantable cardio-defibrillators in adult patients with medically resistant ventricular dysrhythmias has resulted in a positive impact on survival. Because of its size and former lack of programmability, the device has been used rarely in children. Four patients with cardiomyopathy, in whom refractory ventricular dysrhythmias were managed with automatic implantable cardio-defibrillators, are presented. Two of these children are the youngest and smallest known in whom the device has been used; one of them received the first programmable model. The use of the automatic implantable cardio-defibrillator may enhance survival in selected young patients.