Related Experiment Video
Updated: Mar 12, 2026
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Implantable Cardioverter-Defibrillators in Children: A 14-Year Population-Based Study
Marko Bjeloševič1,2, Peter Olejník1,3, Jaroslav Tomko2
1Department of Paediatric Cardiology, Faculty of Medicine Comenius University in Bratislava Bratislava Slovakia.
Insights
Pediatric implantable cardioverter-defibrillator (ICD) use shows significant complications, especially for primary prevention. Newer subcutaneous (S-ICD) and extravascular (EV-ICD) systems offer promising, less invasive alternatives for children.
Area of Science:
- Pediatric Cardiology
- Medical Device Technology
- Electrophysiology
Background:
- Implantable cardioverter-defibrillator (ICD) therapy in children, particularly for primary prevention, has limited data, especially from less affluent regions.
- The increasing adoption of fully subcutaneous (S-ICD) and extravascular (EV-ICD) systems necessitates analysis of their use in pediatric populations.
Purpose of the Study:
- To analyze the epidemiology, indications, complications, and outcomes of pediatric ICD recipients at a tertiary center.
- To evaluate the safety and efficacy of different ICD system types in children.
- To assess the challenges in primary prevention risk stratification for pediatric ICD implantation.
Main Methods:
- A retrospective, population-based, nationwide, single-center study analyzing medical records from 2012 to 2025.
- Inclusion of patients aged 0-18 years who underwent ICD implantation.
- Kaplan-Meier analyses for shock-free and mortality endpoints.
Main Results:
- Forty-nine pediatric patients were included, with an estimated national incidence of 1 ICD implantation per 22,000 live births.
- ICDs were primarily for secondary prevention (80%), with Long QT syndrome and hypertrophic cardiomyopathy as common diagnoses.
- Appropriate shocks occurred in 27% of secondary prevention patients; no appropriate therapies were seen in primary prevention despite higher mortality. Inappropriate shocks affected 22%, and major device complications occurred in 17%.
Conclusions:
- Pediatric ICD therapy is associated with significant device-related morbidity and challenges in primary prevention risk stratification.
- Emerging S-ICD and EV-ICD systems show promise as less invasive alternatives for selected pediatric patients.
- Further research is needed to optimize ICD therapy and risk stratification in pediatric populations.
Aims:
Implantable cardioverter-defibrillator (ICD) therapy in children, particularly for primary prevention, remains under investigation, with limited data from less affluent European countries. With increasing use of fully subcutaneous (S-ICD) and extravascular (EV-ICD) systems, we analyzed epidemiology, indications, complications, and outcomes in pediatric ICD recipients at our tertiary center.
Methods:
This retrospective, population-based, nationwide, single-center study consecutively analyzed medical records from 2012 to 2025. Patients aged 0-18 years who underwent ICD implantation were included. Kaplan-Meier analyses were performed for shock-free and mortality endpoints.
Results:
Forty-nine patients were included, corresponding to an estimated national incidence of approximately one ICD implantation per 22 000 live births. ICDs were predominantly implanted for secondary prevention (80%). Long QT syndrome (32%) and hypertrophic cardiomyopathy (22%) were the most frequent diagnoses. During 207 patient-years of follow-up (median follow-up 4 years), appropriate ICD shocks occurred in 27% of patients exclusively in the secondary prevention group. No appropriate therapies occurred in the primary prevention group despite higher overall mortality. Inappropriate shocks occurred in 22% of patients. Device-related major complications affected 17% of implanted systems. Median transvenous ICD battery longevity was 6.5 years. Overall mortality was 6%, all related to underlying structural heart disease, with no ICD-related deaths. S-ICDs demonstrated a favorable acute and mid-term safety profile in patients without pacing requirements.
Conclusions:
Pediatric ICD therapy is limited by substantial device-related morbidity and imperfect risk stratification for primary prevention. The emerging S-ICD and EV-ICD systems represent promising, less invasive alternatives for selected pediatric patients.
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:23Cardiopulmonary Resuscitation III: AED Use
01:21Cardiopulmonary Resuscitation I: Adult
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:30Introduction Cardiac Emergencies