ICD Outcome in Pediatric Cardiomyopathies

Area of Science:

• Cardiology
• Pediatric Electrophysiology
• Medical Devices

Background:

• Pediatric patients with cardiomyopathies face high risks of malignant arrhythmias and sudden cardiac death (SCD).
• Implantable cardioverter-defibrillators (ICDs) are crucial for preventing SCD in this population.
• Evaluating ICD implantation outcomes in pediatric cardiomyopathy patients is essential.

Purpose of the Study:

• To assess the outcomes of ICD implantation in pediatric patients with cardiomyopathies.
• To compare the efficacy and safety of transvenous ICDs versus subcutaneous ICDs (S-ICDs) in this cohort.

Main Methods:

• A retrospective, single-center study included pediatric patients with cardiomyopathies requiring ICD implantation between 2010 and 2021.
• Outcomes analyzed included appropriate/inappropriate ICD therapy and surgical complications.
• Comparative analysis between transvenous ICD and S-ICD groups.

Main Results:

• Forty-four pediatric patients (mean age 14 years) with various cardiomyopathies received either transvenous (52%) or S-ICDs (48%), primarily for primary prevention (73%).
• Appropriate ICD therapy was delivered in 25% of patients, with no defibrillation failures. Lower age and secondary prevention were risk factors for arrhythmias.
• Overall complication rates were 18% for surgical issues and 7% for inappropriate shocks, with no significant differences between ICD types or cardiomyopathy subgroups.

Conclusions:

• ICD therapy is effective in pediatric patients with cardiomyopathy, demonstrating a low rate of inappropriate shocks.
• Both transvenous and S-ICD systems exhibit comparable outcomes in this population.
• No significant differences in outcomes were observed across different cardiomyopathy subtypes.