Intermuscular S-ICD Implantation in Pediatric Patients

Area of Science:

• Pediatric Cardiology
• Medical Devices
• Surgical Innovation

Background:

• Conventional implantable cardioverter-defibrillators (ICDs) pose significant technical challenges for pediatric implantation.
• Adapting adult S-ICD systems for children requires specialized surgical approaches.

Purpose of the Study:

• To describe a modified surgical technique for subcutaneous ICD (S-ICD) implantation in pediatric patients.
• To evaluate the feasibility and safety of S-ICD implantation in children weighing less than 20kg.

Main Methods:

• A two-incision surgical technique was employed.
• Interfascial dissection involving the serratus anterior and latissimus dorsi muscles was utilized to accommodate the S-ICD device.
• The procedure was performed on pediatric patients, including those with low body weight.

Main Results:

• Successful S-ICD implantation was achieved in three pediatric patients with weights of 19kg, 28kg, and 24kg.
• Two of the implanted patients had a history of cardiorespiratory arrest.
• The adapted surgical technique proved effective for device placement.

Conclusions:

• Intermuscular thoracic implantation of S-ICD is a feasible strategy for pediatric patients.
• This approach may serve as an effective method for primary or secondary prevention of sudden cardiac death in children.
• The modified S-ICD technique addresses the challenges of device implantation in younger patients.