Implantable Cardioverter Defibrillator in a 4‐Month‐Old Infant with Cardiac Arrest Associated with a Vascular Heart Tumor

Abstract

A previously healthy male infant was resuscitated after spontaneous ventricular fibrillation at 9 weeks of age. Echocardiography revealed three tumors in the left ventricle not amenable to complete resection. Despite treatment with antiarrhythmic agents the ventricular arrhythmias continued. When the child was 4 months old and weighed 7 kg an ICD system was implanted using epicardial sense-pacing leads and a superior vena caval lead as a subcutaneous defibrillator coil placed posterior on the left thorax. Shocks were delivered between the subcutaneous coil lead and the intraabdominally placed ICD can. This ICD array system has not been reported previously.

Implantable cardioverter defibrillator implantation in children in The Netherlands

“…During longer follow-up, however, these growing individuals may complain of an increasing number of lead problems. In young infants it seems to be most appropriate to choose an epicardial approach [20,28,30]. By using the epicardial approach, the most useful combination is that of an active generator placed abdominally and epicardial or subcutaneous patches.…”

“…They described 125 patients below the age of 20 years; since then several other reports concerning young patients have been published [1,3,6,9,10,12,13,25,27,31]. ICD implantations in neonates and infants, however, remain limited to case reports [20,28,30]. In the present study, we evaluated the use of ICD therapy in patients aged below 18 years in The Netherlands.…”

Cardiac Tumors and Associated Arrhythmias in Pediatric Patients, With Observations on Surgical Therapy for Ventricular Tachycardia

“…Although most are pathologically benign, they can be associated with serious cardiovascular complications, including intracavitary obstruction, coronary artery compromise, thromboembolic events, and rhythm disturbances (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Data regarding associated arrhythmias and their treatment have been largely limited to case reports or small series (6,8,9,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). The most substantial study to date came from Beghetti et al (20), who identified 56 pediatric patients with various tumor types and described arrhythmias in 11 cases.…”

Malignant Arrhythmias Secondary to a Cardiac Fibroma Requiring Transplantation in a Teenager

“…A review of the literature reveals three cases where unresectable benign tumors causing malignant arrhythmias were managed with the insertion of an AICD. [5][6][7] However, no post-implantation follow-up was reported in those studies. Recall that our patient had two unsuccessful discharges.…”