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Five-year experience with implantable defibrillators in children
R M Hamilton1, P Dorian, R M Gow
1Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario.
Insights
Implantable cardioverter-defibrillators are safe and effective for children aged 4-16 at high risk of sudden cardiac death. No deaths occurred in the study group, with 6 of 11 patients receiving appropriate shocks.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Sudden cardiac death (SCD) is a critical concern in pediatric populations.
- Identifying children at high risk for SCD is essential for timely intervention.
- Implantable cardioverter-defibrillators (ICDs) are established treatments for SCD prevention in adults.
Purpose of the Study:
- To evaluate the safety and efficacy of implantable cardioverter-defibrillators (ICDs) in pediatric patients.
- To assess ICD performance in children with a history of sudden cardiac arrest or high risk for SCD.
Main Methods:
- A retrospective analysis of pediatric patients (aged 4-16 years) who received ICDs over a 5-year period.
- Inclusion of both transvenous and epicardial ICD implantation techniques.
- Monitoring for mortality, device-related complications, and clinically appropriate shocks.
Main Results:
- No mortality was observed in the study cohort during the follow-up period.
- Six out of eleven patients experienced clinically appropriate shocks, indicating device efficacy.
- Both transvenous and epicardial ICDs demonstrated safety and effectiveness in this pediatric group.
Conclusions:
- Implantable cardioverter-defibrillators are a safe and effective therapeutic option for children at high risk of sudden cardiac death.
- ICD implantation can be successfully performed in pediatric patients, regardless of the surgical approach (transvenous or epicardial).
- Further research may explore long-term outcomes and specific indications for ICDs in diverse pediatric cardiac conditions.
Abstract:
Cardioverter-defibrillators were implanted in children aged 4 to 16 years over a 5-year period with no mortality and eventual clinically appropriate shocks in 6 of 11 patients. Both transvenous and epicardial implantable cardioverter-defibrillators were safe and effective in children resuscitated from sudden death or at high risk for sudden death.