What question did this study set out to answer?

To evaluate the feasibility of minimally invasive epicardial cardioverter-defibrillator placement in an infant with treatment-refractory ventricular arrhythmias awaiting cardiac transplantation.

April 5, 2017Interactive Cardiovascular and Thoracic SurgeryOpen Access

Epicardial cardioverter–defibrillator implantation in a 4-month-old infant bridged to heart transplantation

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Why the study?

Does minimally invasive epicardial ICD implantation allow survival and bridging to heart transplantation in a 4-month-old infant with refractory ventricular tachycardia storms?

Key Points

To evaluate the feasibility of minimally invasive epicardial cardioverter-defibrillator placement in an infant with treatment-refractory ventricular arrhythmias awaiting cardiac transplantation.
Evaluated a 4-month-old infant weighing 5 kg presenting with arrhythmic cardiomyopathy, left ventricular non-compaction, ventricular tachycardia storms, prolonged QT interval, and Wolff-Parkinson-White pattern.
Attempted management with antiarrhythmic pharmacotherapy, radiofrequency ablation, and cardiac sympathetic denervation prior to performing minimally invasive epicardial cardioverter-defibrillator implantation.
Standard antiarrhythmic medical therapy, catheter-based radiofrequency ablation, and sympathetic denervation failed to terminate the refractory ventricular tachycardia storms.
Minimally invasive epicardial cardioverter-defibrillator placement successfully restored electrical rhythm stability, ensuring patient survival and serving as a bridge to heart transplantation.

Structured PICO

Does minimally invasive epicardial ICD implantation allow survival and bridging to heart transplantation in a 4-month-old infant with refractory ventricular tachycardia storms?

Population

4-month-old infant weighing 5 kg with arrhythmic cardiomyopathy, left ventricular non-compaction disease, ventricular tachycardia storms, QT prolongation, and Wolff-Parkinson-White pattern, refractory to antiarrhythmic drugs, radiofrequency ablation, and sympathetic denervation

Intervention

Minimally invasive epicardial implantable cardioverter-defibrillator (ICD) implantation

Outcome

Survival and bridging to heart transplantationhard clinical

Minimally invasive epicardial ICD implantation can be successfully performed in very low weight infants as a bridge to heart transplantation.

Discussion

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Implication

Supports feasibility of epicardial ICD in 5-kg infants; leaves open prospective validation of safety and efficacy.

Cite This Study

Carro et al. (2017) studied this question.

synapsesocial.com/papers/6a7415648cee7e0fe6a8ce73 https://doi.org/10.1093/icvts/ivx129

Topics

Ventricular arrhythmias Cardiac device therapy Congenital heart disease adults Heart transplantation

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Epicardial cardioverter–defibrillator implantation in a 4-month-old infant bridged to heart transplantation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Epicardial cardioverter–defibrillator implantation in a 4-month-old infant bridged to heart transplantation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider