Cardiomyopathy and the Use of Implanted Cardio‐Defibrillators in Children

Abstract

Children and adults with cardiomyopathy and ventricular dysrhythmias have a uniformly poor prognosis, despite medical therapy. The use of automatic implantable cardio-defibrillators in adult patients with medically resistant ventricular dysrhythmias has resulted in a positive impact on survival. Because of its size and former lack of programmability, the device has been used rarely in children. Four patients with cardiomyopathy, in whom refractory ventricular dysrhythmias were managed with automatic implantable cardio-defibrillators, are presented. Two of these children are the youngest and smallest known in whom the device has been used; one of them received the first programmable model. The use of the automatic implantable cardio-defibrillator may enhance survival in selected young patients.

Nontransvenous Implantable Cardioverter Defibrillator Systems: Not Just for Small Pediatric Patients

“…Cardioverter‐defibrillator implantation in pediatric patients in the early and mid‐1980s followed the initial use of epicardial patch systems in adults but was restricted to older, bigger children, and adolescents due to the large generator device 5–7 . After the development of smaller cardioverter‐defibrillators, the first reports of epicardial ICD systems in very small children appeared that used the epicardial patch system 8,9 .…”

Sudden cardiac death and the use of implantable cardioverter-defibrillators in pediatric patients. The Pediatric Electrophysiology Society.

“…9 In contrast to the proliferation of clinical studies analyzing the use of ICDs in adults resuscitated from or at risk for SCD,10 only a few, descriptive studies have been published regarding the use of ICDs in young patients. [11][12][13] Thus, this multicenter, international survey was initiated under the auspices of the Pediatric Electrophysiology Society to analyze the patient characteristics, device utilization, and prognostic factors related to outcome in young patients who had undergone ICD implantation following an episode of lifethreatening ventricular tachycardia or resuscitation from SCD.…”

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“…Pediatric patients, however, still represent less than 1% of all persons with ICDs [5] and the clinical experience in young patients remains limited. Previous reports have consisted of retrospective surveys of multiple institutions [6][7][8][9], small series [10][11][12][13][14][15], and case reports [16,17]. The purpose of this study is to report a single center's experience with this evolving technology and to provide data on the indications, efficacy and outcomes of ICD use in young patients.…”