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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Midterm experience with implantable cardioverter-defibrillators in children and young adults

Alpay Çeliker1, Haşim Olgun, Tevfik Karagoz

  • 1Department of Pediatric Cardiology, Acıbadem University, Maslak Hospital, İstanbul, Turkey.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|September 21, 2010
PubMed

Insights

Implantable cardioverter-defibrillators (ICDs) are safe for children at high risk of sudden cardiac death, but lead complications and frequent shocks, often due to T-wave oversensing, impact quality of life.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Implantable cardioverter-defibrillators (ICDs) are crucial for managing life-threatening arrhythmias in pediatric patients.
  • Experience with ICD implantation in children with diverse etiologies is valuable for refining treatment strategies.

Purpose of the Study:

  • To review the single-center experience with implantable cardioverter-defibrillator (ICD) implantation in pediatric patients.
  • To evaluate the safety, efficacy, and complications associated with ICDs in children with various underlying conditions.

Main Methods:

  • Retrospective review of pediatric patients who underwent ICD implantation between October 2001 and December 2008.
  • Data collection from medical records and computerized databases.
  • Analysis of patient demographics, diagnoses, device types, shock data, and complications.

Main Results:

  • Twenty-eight pediatric patients (median age 12 years) received ICDs for secondary (n=22) or primary (n=6) prevention.
  • Ion-channel diseases and cardiomyopathy were the most common etiologies.
  • Appropriate shocks occurred in 68.2% of secondary and 33.3% of primary prevention groups.
  • Inappropriate shocks (n=42) occurred in 31.8% of patients, primarily due to T-wave oversensing.
  • Lead complications occurred in six patients.

Conclusions:

  • ICDs are safe and effective in interrupting malignant arrhythmias in high-risk pediatric patients.
  • Lead complications and a high incidence of both appropriate and inappropriate shocks necessitate careful device programming.
  • T-wave oversensing is a significant issue contributing to inappropriate shocks, requiring optimized programming to improve patient quality of life.
Abstract

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