Subcutaneous implantable cardioverter defibrillators in children, young adults and patients with congenital heart disease

Bordachar, Pierre; Marquié, Christelle; Pospiech, Thomas; Pasquié, Jean‐Luc; Jalal, Zakaria; Haı̈ssaguerre, Michel; Thambo, Jean-Benoît

doi:10.1016/j.ijcard.2015.09.083

Cited by 52 publications

(35 citation statements)

References 35 publications

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“…Little experience is available regarding the use of subcutaneous ICDs in patients with ACHD, but their number is steadily increasing. They are a promising alternative in younger patients with limited venous access to the ventricle or with intracardiac shunts increasing the risk of systemic emboli …”

Section: Discussionmentioning

confidence: 99%

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Long‐term follow‐up of adult patients with congenital heart disease and an implantable cardioverter defibrillator

Cruz

Monteiro

Portugal

et al. 2019

Congenital Heart Disease

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Objective Sudden cardiac death is common in the adult congenital heart disease (ACHD) population. Knowledge and experience about the use of implantable cardioverter defibrillators (ICD) in ACHD patients is very limited. We aimed to characterize a cohort of patients with ACHD and ICDs. Design Thirty consecutive ACHD patients submitted to an ICD implantation in a single tertiary center were evaluated. Data on baseline clinical features, heart defect, indication for ICD, type of device, appropriate therapies, ICD‐related complication, and mortality during follow‐up were collected. Results Of the 30 patients, 56.7% received appropriate therapies due to ventricular tachycardia (VT) or ventricular fibrillation (VF). The rate of inappropriate therapies and device‐related complications was 33.3%. Secondary prevention and primary prevention patients with class I indications for ICD had more appropriate therapies than complication, but this relationship was reversed for patients with class II indications. Remote monitoring played an important role in diagnosing new atrial arrhythmias before scheduled visits in 46.2% of patients, leading to a change in medication. VT/VF episodes were associated with a composite of death, cardiac transplantation, and hospital admission (OR 13.0; 95% CI: 2.1‐81.5). Conclusion ICDs are not only useful in preventing SCD, but also have a major role in diagnosing atrial tachyarrhythmias ahead of scheduled visits. Although improvements in ICD technology might reduce complications and inappropriate therapies, adequate selection of candidates for primary prevention still remains difficult because of the lack of clear indications.

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Section: Discussionmentioning

confidence: 99%

“…Subcutaneous ICDs may be especially valuable to avoid lead failure, but still pose the problems of inappropriate therapies and infection . Furthermore, as the device lacks the features of anti‐tachycardia and chronic antibradycardia pacing, its indications are limited.…”

Section: Discussionmentioning

confidence: 99%

Long‐term follow‐up of adult patients with congenital heart disease and an implantable cardioverter defibrillator

Cruz

Monteiro

Portugal

et al. 2019

Congenital Heart Disease

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“…Most of the inappropriate therapies are attributable to lead failure, followed by supraventricular tachycardias and over-sensing (56,62,63). Consequently, the subcutaneous ICD has recently emerged as an appealing alternative to the intra-cardiac device for a carefully selected subgroup of patients (64). In addition, for some patients at potentially high risk of SCD but not meeting definite indications for implantation of a permanent ICD, the wearable cardioverter-defibrillator can be a short-term solution (65,66).…”

Section: Risk Stratification and Primary Prevention Icd Therapy In Esmentioning

confidence: 99%

Prevention of sudden cardiac death in children and young adults

Chugh

2017

Progress in Pediatric Cardiology

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In the present review, we summarize current approaches to the prevention of sudden cardiac death (SCD) in children and young adults, focusing on age less than 35 years. SCD in the young is rare, but devastating from the societal perspective. While coronary artery disease is the main etiology of SCD in the older age groups, conditions such as cardiomyopathies and electrical channelopathies are more likely to be found in the young. In the majority of younger cases, cardiac arrest can be the first recognized manifestation of the underlying cardiac pathology, although some have experienced cardiovascular symptoms prior to the SCD. Since identification of a cardiac disease is pivotal for implementation of appropriate preventive measures, measures such as electrocardiographic screening in subpopulations such as athletes have been proposed. However, these efforts are impeded by the large number of individuals needed to test in order to find one with cardiac disease, leading to significant rates of false positive findings and high costs. When a high-risk cardiac condition is identified in a young person, measures of lifestyle modification, appropriate medical treatment and ICD implantation in selected individuals based on risk stratification are warranted. Nevertheless, the benefits of lifelong ICD therapy need to be balanced with long-term complications and quality of life.

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“…This novel technology seems promising and particularly beneficial in patients with conditions associated with higher risk of infections (dialysis, diabetes mellitus) or in those who had experienced previous complications related to transvenous leads. The clinical benefits of S-ICD therapy have been also documented in young patients facing a lifetime of device therapy [12,13].…”

Section: Introductionmentioning

confidence: 99%

Initial experience with the subcutaneous implantable cardioverter-defibrillator with the real costs of hospitalization analysis in a single Polish center

et al. 2019

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Subcutaneous implantable cardioverter defibrillators in children, young adults and patients with congenital heart disease

Cited by 52 publications

References 35 publications

Long‐term follow‐up of adult patients with congenital heart disease and an implantable cardioverter defibrillator

Long‐term follow‐up of adult patients with congenital heart disease and an implantable cardioverter defibrillator

Prevention of sudden cardiac death in children and young adults

Initial experience with the subcutaneous implantable cardioverter-defibrillator with the real costs of hospitalization analysis in a single Polish center

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