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Published on: February 28, 2012
Current Trends in Implantable Cardioverter-Defibrillator Therapy in Children - Results From the JCDTR Database
Hiroko Asakai1, Akihiko Shimizu2, Takeshi Mitsuhashi3
1Department of Pediatrics, The University of Tokyo Hospital.
Insights
Pediatric implantable cardioverter defibrillator (ICD) use in Japan remained stable over a decade, with approximately 20 children implanted annually, primarily for secondary prevention of cardiac events.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Medical Device Technology
Background:
- Implantable cardioverter defibrillators (ICDs) are increasingly utilized in pediatric populations.
- Understanding trends in pediatric ICD implantation is crucial for clinical practice and device development.
Purpose of the Study:
- To analyze the trends and characteristics of pediatric ICD implantation in Japan between 2006 and 2016.
- To identify common diagnoses and indications for ICD implantation in children.
Main Methods:
- Data sourced from the Japanese Cardiac Device Treatment Registry (JCDTR) from 2006 to 2016.
- Included 201 patients under 18 years old who received an ICD.
- Analyzed patient demographics, cardiac diagnoses, and implantation indications.
Main Results:
- A total of 201 pediatric ICD implantations were recorded, with a median age of 16 years.
- Primary electrical disease (67%) and cardiomyopathy (26%) were the most common diagnoses.
- Implantation for primary prevention was infrequent (15%), with secondary prevention dominating, especially in younger children (≤12 years).
Conclusions:
- Pediatric ICD implantation in Japan showed no significant increase over the decade, averaging around 20 cases per year.
- The majority of implantations were for secondary prevention, with no substantial change in age distribution.
- Younger children may be underrepresented due to the registry's adult cardiology focus.
Background:
Implantable cardioverter defibrillators (ICDs) are being used with increasing frequency in children. Our aim was to examine the current trend of pediatric ICD implantation in Japan.
Methods And Results:
Data was extracted from the Japanese Cardiac Device Treatment Registry (JCDTR), a nation-wide registry started in 2006. All patients aged less than 18 years who had an ICD implantation registered between 2006 and 2016 were included in the analysis. A total of 201 patients were included, with a median age of 16 years (range 1-18). The underlying cardiac diagnosis was primary electrical disease (67%), cardiomyopathy (26%) and congenital heart disease (4%), with idiopathic ventricular fibrillation (29%) and long QT syndrome (21%) being the 2 most common diagnoses. Implantation indication was primary prevention in only 30 patients (15%). There were 27 patients (13%) aged ≤12 years, with a larger proportion of patients with cardiomyopathy (33%). The indication in younger children was secondary prevention in all cases. Younger children may be under-represented in our study given the nature of the database as it is a predominantly adult cardiology database.
Conclusions:
In the past decade, ICD implantation has been performed in approximately 20 children per year in Japan, mostly for secondary prevention. There was no increase in the trend nor a change in age distribution.
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