Key result
In children supported with a ventricular assist device, the presence of an implantable cardioverter-defibrillator did not confer a survival benefit compared to no ICD (p=0.342).
Why the study?
Data on the use and outcome of children supported with a ventricular assist device who have an implantable cardioverter-defibrillator remain poor.
Does the concomitant presence of an ICD improve survival in children supported with a ventricular assist device?
Cohort (n=303)
Yes
Does the concomitant presence of an ICD improve survival in children supported with a ventricular assist device?
The use of ICDs in pediatric patients supported with a VAD is low (7%) and does not appear to confer a survival benefit compared to VAD support alone.
BACKGROUND: Data on the use and outcome of children on ventricular assist device (VAD) support provided with an implantable cardioverter-defibrillator (ICD) remains poor. METHODS: A retrospective analysis of the EUROMACS database on children supported with VAD < 19 years of age from January 1, 2009 to April 1, 2020. Patients with missing data on status of ICD, missing baseline and/or follow up information were excluded. The primary independent variable of interest was the concomitant presence or absence of an ICD at the time of VAD placement. Kaplan-Meier survival analysis was performed to evaluate survival differences between children on VAD with and without an ICD. RESULTS: Out of 303 patients provided with a VAD, 7% (7♀, 15♂) had an ICD implanted and formed the study group. Median age was 14 years, median weight was 43.5 kg, and median BSA was 1.39. Median Intermacs stage was 2 (range: 1-7). Seventeen patients (77%) were transplanted, 4 (18%) died while on support, and 1 (5%) was weaned from device after myocardial recovery. Median time on support was 68 days compared to 361 days in the control group (p: 0.01). Three patients underwent device exchange due to thrombus formation in the pump. There was no difference in survival between groups (p = 0.342). CONCLUSION: The presence of ICD in pediatric patients supported with a VAD is low (7%). Children on VAD support provided with an ICD do not have a survival benefit compared to children without an ICD.
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Schweiger et al. (2023) conducted a cohort in Ventricular assist device (VAD) support (n=303). Implantable cardioverter-defibrillator (ICD) vs. No implantable cardioverter-defibrillator was evaluated on Survival (p=0.342). In children supported with a ventricular assist device, the presence of an implantable cardioverter-defibrillator did not confer a survival benefit compared to no ICD (p=0.342).
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