Johannes C von Alvensleben1, Brynn Dechert2, David J Bradley2, Frank A Fish3, Jeremy P Moore4, Thomas A Pilcher5, Carolina Escudero6, Scott R Ceresnak7, Sit Yee Kwok8, Seshadri Balaji9, Peter F Aziz10, John Papagiannis11, Daniel Cortez12, Jason Garnreiter13, Adam Kean14, Michal Schäfer15, Kathryn K Collins15. 1. Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA. Electronic address: johannes.vonalvensleben@childrenscolorado.org. 2. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, Michigan, USA. 3. Monroe Carell Jr. Children's Hospital, Nashville, Tennessee, USA. 4. University of California Los Angeles Medical Center, Division of Pediatric Cardiology, Los Angeles, California, USA; University of California Medical Center, Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, California, USA. 5. Primary Children's Hospital, University of Utah, Salt Lake City, Utah, USA. 6. Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada. 7. Lucile Packard Children's Hospital, Stanford University, Palo Alto, California, USA. 8. Queen Mary Hospital, Hong Kong, China. 9. Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Oregon, USA. 10. Cleveland Clinic, Cleveland, Ohio, USA. 11. Children's Mercy, University of Missouri-Kansas City, Kansas City, Missouri, USA. 12. University of Minnesota Health, University of Minnesota, Rochester, Minnesota, USA. 13. SSM Health Cardinal Glennon Children's Hospital-St. Louis, St. Louis University, St. Louis, Missouri, USA. 14. Riley Hospital for Children, Indianapolis, Indiana, USA. 15. Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.
Abstract
OBJECTIVES: The primary goal of this study was to evaluate the implant experience and midterm results of subcutaneous implantable cardioverter-defibrillators (S-ICDs) in pediatric patients and those with congenital heart disease. BACKGROUND: The S-ICD was developed to avoid the lead-related complications associated with transvenous systems. The absence of intravascular or intracardiac components offers potential advantages to pediatric patients and those with congenital heart disease. METHODS: This international, multicenter, retrospective, standard-of-care study was conducted through the Pediatric & Congenital Electrophysiology Society. Complications at 30 and 360 days, inappropriate shocks, and delivery of appropriate therapy were assessed. RESULTS: The study included 115 patients with a median follow-up of 32 (19 to 52) months. Median age was 16.7 years (14.8 to 19.3 years), 29% were female, and 55% had a primary prevention indication. Underlying disease substrate was cardiomyopathy (40%), structural heart disease (32%), idiopathic ventricular fibrillation (16%), and channelopathy (13%). The complication rate was 7.8% at 30 days and 14.7% at 360 days. Overall, inappropriate shocks occurred in 15.6% of patients, with no single clinical characteristic reaching statistical significance. At implant, 97.9% of patients had successful first shock conversion with 96% requiring ≤65 J. Appropriate therapy was delivered to 11.2% of patients with an annual incidence of 3.9% and an acute first shock conversion success rate of 92.5%. CONCLUSIONS: This study found that in a heterogeneous population of pediatric patients and those with congenital heart disease, the S-ICD had comparable rates of complications, inappropriate shocks, and conversion efficacy compared with previously published studies on transvenous systems in similar populations.
OBJECTIVES: The primary goal of this study was to evaluate the implant experience and midterm results of subcutaneous implantable cardioverter-defibrillators (S-ICDs) in pediatric patients and those with congenital heart disease. BACKGROUND: The S-ICD was developed to avoid the lead-related complications associated with transvenous systems. The absence of intravascular or intracardiac components offers potential advantages to pediatric patients and those with congenital heart disease. METHODS: This international, multicenter, retrospective, standard-of-care study was conducted through the Pediatric & Congenital Electrophysiology Society. Complications at 30 and 360 days, inappropriate shocks, and delivery of appropriate therapy were assessed. RESULTS: The study included 115 patients with a median follow-up of 32 (19 to 52) months. Median age was 16.7 years (14.8 to 19.3 years), 29% were female, and 55% had a primary prevention indication. Underlying disease substrate was cardiomyopathy (40%), structural heart disease (32%), idiopathic ventricular fibrillation (16%), and channelopathy (13%). The complication rate was 7.8% at 30 days and 14.7% at 360 days. Overall, inappropriate shocks occurred in 15.6% of patients, with no single clinical characteristic reaching statistical significance. At implant, 97.9% of patients had successful first shock conversion with 96% requiring ≤65 J. Appropriate therapy was delivered to 11.2% of patients with an annual incidence of 3.9% and an acute first shock conversion success rate of 92.5%. CONCLUSIONS: This study found that in a heterogeneous population of pediatric patients and those with congenital heart disease, the S-ICD had comparable rates of complications, inappropriate shocks, and conversion efficacy compared with previously published studies on transvenous systems in similar populations.
Authors: Piotr Wieniawski; Michał Buczyński; Marcin Grabowski; Joachim Winter; Bożena Werner Journal: Int J Environ Res Public Health Date: 2022-09-16 Impact factor: 4.614
Authors: Maully J Shah; Michael J Silka; Jennifer N Avari Silva; Seshadri Balaji; Cheyenne M Beach; Monica N Benjamin; Charles I Berul; Bryan Cannon; Frank Cecchin; Mitchell I Cohen; Aarti S Dalal; Brynn E Dechert; Anne Foster; Roman Gebauer; M Cecilia Gonzalez Corcia; Prince J Kannankeril; Peter P Karpawich; Jeffery J Kim; Mani Ram Krishna; Peter Kubuš; Martin J LaPage; Douglas Y Mah; Lindsey Malloy-Walton; Aya Miyazaki; Kara S Motonaga; Mary C Niu; Melissa Olen; Thomas Paul; Eric Rosenthal; Elizabeth V Saarel; Massimo Stefano Silvetti; Elizabeth A Stephenson; Reina B Tan; John Triedman; Nicholas H Von Bergen; Philip L Wackel Journal: Indian Pacing Electrophysiol J Date: 2021-07-29