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Published on: June 12, 2021

ICD therapy in children and young adults: low incidence of inappropriate shock delivery

Micha P Botsch1, Birgit Franzbach, Bernd Opgen-Rhein

  • 1Department of Pediatric Cardiology and Congenital Heart Disease, Charité Universitaetsmedizin, Berlin, Germany. micha.botsch@charite.de

Pacing and Clinical Electrophysiology : PACE
|February 13, 2010
PubMed

Insights

Implantable cardioverter defibrillator (ICD) therapy is feasible in pediatric patients. Combining antiarrhythmic drugs, ablation, and tailored programming significantly reduces inappropriate shocks in young patients receiving ICDs.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Implantable cardioverter defibrillator (ICD) therapy is a viable treatment for life-threatening arrhythmias in pediatric patients.
  • However, high rates of inappropriate shock delivery have been reported in recent studies.

Purpose of the Study:

  • To evaluate the incidence of inappropriate shock delivery in pediatric patients receiving ICDs.
  • To identify strategies that minimize inappropriate shocks in this population.

Main Methods:

  • Retrospective analysis of 33 pediatric patients who received ICDs between 2001 and 2007.
  • Data collected included cardiac disorders, arrhythmias, medications, ablation procedures, device programming, and ICD therapies.
  • Patients received tailored treatment including antiarrhythmic drugs and ablation procedures.

Main Results:

  • A total of 33 pediatric patients underwent ICD implantation.
  • Most patients received antiarrhythmic drugs (85%), and 27% underwent ablation procedures.
  • Only two inappropriate shocks (delivered for atrial flutter) occurred among 63 total therapies in 11 patients, with 22 patients receiving no therapies.

Conclusions:

  • A multimodal approach combining antiarrhythmic drug therapy, ablation procedures, and individualized ICD programming effectively reduces inappropriate shock delivery in children and young adults.
  • Improved device and lead technology further contributes to minimizing adverse events.
Abstract

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