Implantable cardioverter defibrillator therapy for life-threatening arrhythmias in young patients.
J Interv Card Electrophysiol
; 6(3): 235-44, 2002 Jul.
Article
en En
| MEDLINE
| ID: mdl-12154326
OBJECTIVES: This study examined the indications, efficacy and outcomes of implantable cardioverter defibrillator (ICD) use in the pediatric population. BACKGROUND: ICDs are first-line therapy for adults resuscitated from sudden cardiac death (SCD) or at high risk for life-threatening ventricular arrhythmias. Use of ICDs in children and young adults is infrequent and there are few data regarding this group. METHODS: We abstracted and analyzed data for all patients in whom ICDs were implanted. RESULTS: A total of 38 devices were implanted in 27 patients. Age ranged from 6 to 26 years (mean, 14) and weight ranged from 16 to 124 kg (mean, 47). Diagnoses included long QT syndrome (9), hypertrophic cardiomyopathy [6], repaired congenital heart disease [5];, and idiopathic ventricular tachycardia/fibrillation [4]. Indications comprised resuscitated SCD [15], syncope [9], and life-threatening ventricular arrhythmia [3]. Initial device placement was infraclavicular in 13, abdominal in 13 and intrathoracic in 1. Epicardial leads were used with 5 systems. A single coil lead was used in 17. Seven patients, all previously resuscitated from SCD, experienced 88 appropriate successful discharges. There were 6 inappropriate discharges in 3 patients. Mean time to device replacement was 3.1 years (n = 11). Complications included 2 infected systems, 2 lead dislodgments, 2 lead fractures, 1 post-pericardiotomy syndrome, 1 adverse event with defibrillation threshold (DFT); testing, and 1 patient with psychiatric sequelae. No deaths occurred with implanted ICDs. CONCLUSIONS: These data demonstrate that ICDs provide safe and effective therapy in young patients. The indications for ICDs as primary preventive therapy remain uncertain.
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Bases de datos:
MEDLINE
Asunto principal:
Enfermedades Cardiovasculares
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Muerte Súbita Cardíaca
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Taquicardia Ventricular
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Desfibriladores Implantables
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Cardiopatías Congénitas
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
J Interv Card Electrophysiol
Asunto de la revista:
CARDIOLOGIA
Año:
2002
Tipo del documento:
Article
País de afiliación:
Estados Unidos