Use of implantable cardioverter-defibrillators in pediatric patients

Automatic implantable cardioverter-defibrillator use has become widespread in the prevention of sudden death in at-risk populations. The compelling safety and efficacy data in numerous large, blinded trials on adult patients have led to increasing use of these devices in pediatric patients. Although there are no prospective data to support device therapy in pediatric patients, several large, retrospective studies suggest that pediatric patients are likely to enjoy the same reduction in mortality as adult patients, with a slightly higher rate of complications from the device implant. Data on the use of these devices in pediatric patients for several different indications exist but are limited to retrospective reviews with small numbers and short follow-up. Large prospective trials are needed to assess the safety and efficacy of these devices in children and the influence of implant technique, patient growth, and programmed parameters on overall outcome.