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ICD Outcome in Pediatric Cardiomyopathies

Massimo Stefano Silvetti1, Ilaria Tamburri1, Marta Campisi1

  • 1Pediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy.

Journal of Cardiovascular Development and Disease
|February 24, 2022
PubMed

Insights

Implantable cardioverter-defibrillators (ICDs) are effective in pediatric patients with cardiomyopathy, preventing sudden cardiac death. Both transvenous and subcutaneous ICDs showed similar outcomes, with low complication rates.

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.
Abstract

Keywords:
cardiomyopathiesimplantable cardioverter defibrillator (ICD)pediatric agesudden cardiac death

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