Implantable cardioverter defibrillator therapy in children and young adults was associated with a low incidence of inappropriate shocks, with only 2 inappropriate shocks out of 63 total therapies.
Observational (n=33)
No
Does a combination of specific drug therapy, ablation, and individual programming reduce inappropriate ICD shocks in children and young adults?
In pediatric and young adult ICD recipients, individualized programming combined with antiarrhythmic drugs and ablation results in a very low rate of inappropriate shocks.
INTRODUCTION: Implantable cardioverter defibrillator (ICD) therapy of life-threatening arrhythmias in pediatric patients is feasible; however, recent studies report a high incidence of inappropriate shock deliveries. METHODS: The data of all recipients of an ICD at the Charité, Department of Pediatric Cardiology, between January 2001 and November 2007 were retrospectively analyzed regarding underlying cardiac disorders, arrhythmias, medication, ablation procedures, leads and devices, programming, and ICD therapies. RESULTS: A total of 33 patients underwent ICD implantation, with a median age of 16.5 years (range 8-36 years) and a mean weight of 61 +/- 20.9 kg. Underlying cardiac disorders were electrical heart disease (27%), cardiomyopathy (30%), congenital heart disease (33%), and others (9%). Eighty-five percent received antiarrhythmic drugs, and 12 ablation procedures were performed in nine patients (27%). The devices were programmed individually according to the underlying diseases and arrhythmias. During follow-up, a total of 63 shock therapies were delivered in 11 patients, while a majority of 34 shocks occurred in one patient (no therapies in 22 of 33 patients). Only two such therapies were inappropriate, both delivered for atrial flutter. CONCLUSIONS: In children and young adults receiving ICD therapy, the combination of strategies to prevent ventricular arrhythmias using specific drug therapy, ablation procedures, and individual programming with improved devices and leads causes a low incidence of inappropriate shock delivery.
BOTSCH et al. (Mon,) conducted a observational in Life-threatening arrhythmias (n=33). Implantable cardioverter defibrillator (ICD) therapy was evaluated on Incidence of inappropriate shock delivery. Implantable cardioverter defibrillator therapy in children and young adults was associated with a low incidence of inappropriate shocks, with only 2 inappropriate shocks out of 63 total therapies.