Vol 60, No 3 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
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Implantable cardioverter-defibrillators in children

Bożena Werner, Andrzej Przybylski, Beata Kucińska, Michał Lewandowski, Hanna Szwed, Maria Wróblewska-Kałużewska
Kardiol Pol 2004;60(3):243-246.
Vol 60, No 3 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: Implantable cardioverter-defibrillators (ICD) have been increasingly used in adult patients for the prevention of sudden cardiac death (SCD). The usefulness and feasibility of ICD implantation in children have been less well established.
Aim: To analyse indications, results and safety of ICD therapy in children.
Methods: ICDs were implanted in seven children, aged from 6 to 17 years. All patients underwent cardiological evaluation which included analysis of medical history, physical examination, chest x-ray, standard ECG, 24-hour Holter ECG monitoring and echocardiography.
Results: In five children devices were implanted due to aborted sudden death (ventricular fibrillation) whereas in the remaining two - as a primary prevention of SCD. Three children had hypertrophic cardiomyopathy, one - dilated cardiomyopathy, one - mitral valve prolapse and QT prolongation, one - congenital long QT syndrome and the remaining patient - idiopathic ventricular tachycardia. Single-chamber devices were implanted in six children, and dual-chamber system - in one patient. In all patients endocardial leads were implanted and ICD pocket was formed under the greater pectoral muscle. During follow-up ranging between four months to 5.4 years, four children developed ventricular fibrillation or ventricular tachycardia which were terminated by appropriate ICD discharges.
Conclusions: 1. ICD implantation in children is effective in the prevention of SCD. 2. In our population, the most frequent indications for device implantation were life-threatening ventricular arrhythmias occurring in patients with cardiomyopathy. 3. Cardiac arrest due to ventricular fibrillation may occur in children without a history of aborted SCD. 4. ICD implantation in children is feasible and safe.

Abstract

Background: Implantable cardioverter-defibrillators (ICD) have been increasingly used in adult patients for the prevention of sudden cardiac death (SCD). The usefulness and feasibility of ICD implantation in children have been less well established.
Aim: To analyse indications, results and safety of ICD therapy in children.
Methods: ICDs were implanted in seven children, aged from 6 to 17 years. All patients underwent cardiological evaluation which included analysis of medical history, physical examination, chest x-ray, standard ECG, 24-hour Holter ECG monitoring and echocardiography.
Results: In five children devices were implanted due to aborted sudden death (ventricular fibrillation) whereas in the remaining two - as a primary prevention of SCD. Three children had hypertrophic cardiomyopathy, one - dilated cardiomyopathy, one - mitral valve prolapse and QT prolongation, one - congenital long QT syndrome and the remaining patient - idiopathic ventricular tachycardia. Single-chamber devices were implanted in six children, and dual-chamber system - in one patient. In all patients endocardial leads were implanted and ICD pocket was formed under the greater pectoral muscle. During follow-up ranging between four months to 5.4 years, four children developed ventricular fibrillation or ventricular tachycardia which were terminated by appropriate ICD discharges.
Conclusions: 1. ICD implantation in children is effective in the prevention of SCD. 2. In our population, the most frequent indications for device implantation were life-threatening ventricular arrhythmias occurring in patients with cardiomyopathy. 3. Cardiac arrest due to ventricular fibrillation may occur in children without a history of aborted SCD. 4. ICD implantation in children is feasible and safe.
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Keywords

implantable cardioverter-defibrillator - children

About this article
Title

Implantable cardioverter-defibrillators in children

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 60, No 3 (2004)

Pages

243-246

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2004;60(3):243-246.

Keywords

implantable cardioverter-defibrillator - children

Authors

Bożena Werner
Andrzej Przybylski
Beata Kucińska
Michał Lewandowski
Hanna Szwed
Maria Wróblewska-Kałużewska

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