Related Experiment Video
Updated: Mar 23, 2026
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Subcutaneous defibrillator implantation in pediatric patients
İlker Ertuğrul1, Tevfik Karagöz1, Hakan Aykan1
1Department of Pediatric Cardiology, Faculty of Medicine, Hacettepe University, Ankara-Turkey.
Insights
Subcutaneous defibrillator systems offer a safe alternative for pediatric patients when transvenous leads are not feasible. Close follow-up is crucial due to potential lead issues in growing children.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Medical Devices
Background:
- Sudden cardiac death, though rare in children, necessitates defibrillator systems for conditions like cardiomyopathy and post-surgical repair.
- Transvenous defibrillator lead systems face limitations in pediatric patients due to small body size and vascular access challenges.
- Subcutaneous array leads with abdominal generators present a viable alternative for pediatric defibrillator implantation.
Purpose of the Study:
- To evaluate the safety and efficacy of subcutaneous defibrillator (SCD) systems in pediatric patients.
- To assess SCD system performance in children unsuitable for transvenous lead placement.
- To identify potential complications and long-term outcomes associated with SCDs in a pediatric cohort.
Main Methods:
- Retrospective study of 13 pediatric patients implanted with subcutaneous defibrillator systems between September 2010 and March 2015.
- SCD system implantation was chosen for patients not amenable to transvenous lead placement.
- Data collected on patient demographics, diagnoses, lead revisions, shock events, and mortality.
Main Results:
- Median patient age was 4.1 years, median weight 12.1 kg. Diagnoses included long-QT syndrome, aborted cardiac arrest, hypertrophic cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy.
- Five patients required subcutaneous lead revision; one experienced inappropriate shock and lead fracture.
- No perioperative complications or deaths were reported, with appropriate shocks observed in three patients.
Conclusions:
- Subcutaneous defibrillator systems are safe and effective for pediatric patients when transvenous methods are contraindicated.
- High growth rates in children can lead to lead failures, necessitating close patient follow-up.
- SCD systems provide a crucial therapeutic option for pediatric patients at risk of sudden cardiac death.
Objective:
Although sudden cardiac death is rare in children, an intracardiac defibrillator system is indicated in children with various types of cardiomyopathy, primary electrical diseases, and after surgical repair of congenital heart defects. The use of transvenous defibrillator lead systems is limited in pediatric patients because of a small body size and/or limited vascular access. Subcutaneous array leads combined with an abdominally placed generator can enable implantation.
Method:
This is a retrospective study of 13 patients who underwent subcutaneous defibrillator implantation between September 2010 and March 2015. The subcutaneous system was preferred because patients were not amenable to transvenous lead placement.
Results:
The median patient age was 4.1 years, and the median patient weight was 12.1 kg. Diagnoses of patients were long-QT syndrome in 6, aborted cardiac arrest with left ventricular non-compaction in 3, hypertrophic cardiomyopathy with sustained ventricular tachycardia in 3, and arrythmogenic right ventricular cardiomyopathy in 1. Revision of the subcutaneous lead was required in 5 patients 2-26 months after the implantation. Appropriate shocks were observed in three patients. Inappropriate shock and lead fractures were observed in one patient during the follow-up period. The failure of therapy was observed in one patient. There were no perioperative complications and no early or late deaths.
Conclusion:
Subcutaneous defibrillator systems are safe and effective in pediatric patients when the transvenous method is risky and contraindicated. Because the high growth rate in this population leads to lead failures, a close follow-up of this population is essential.
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:23Cardiopulmonary Resuscitation III: AED Use