Key result
Pediatric ICDs deliver appropriate shocks in ~44% of patients over five years.
Why the study?
Data on clinical outcomes of ICD therapy in Asian pediatric patients are scarce, motivating evaluation of ICD use and outcomes in Korean children.
Cohort (n=99)
Yes
In Korean pediatric patients, ICD therapy demonstrates a substantial appropriate shock rate (44%) but is also associated with high rates of inappropriate shocks (33%) and device-related complications (17%).
Low primary-prevention ICD use persists in Korean children despite substantial appropriate shocks; leaves open optimal pediatric indications in Asia.
BACKGROUND: Implantable cardioverter-defibrillator (ICD) therapy is important for the prevention of sudden cardiac death, but data on clinical outcomes of ICD therapy in Asian pediatric patients are scarce. The aim of this Korean multicenter study was to evaluate the current state and elucidate the clinical outcomes of ICD therapy in children. METHODS AND RESULTS: Data from 5 pediatric cardiology centers were retrospectively collected from 2007 to 2019. Altogether, 99 patients were enrolled (mean age 13.9±4.1 years). The most common underlying disease was a primary electrical disease (56%). An ICD was implanted for primary prevention in 19%. Appropriate shock occurred in 44% of patients at a median of 1.6 years after implantation. There was no significant difference in the appropriate shock rate between patients with primary and secondary prevention indications (32% vs. 48%, respectively). A total of 33 patients (33%) experienced inappropriate shock, which was associated with primary electrical disease and follow-up duration on multivariate analysis. 17% of patients had ICD-related complications. CONCLUSIONS: The utilization rate of ICD for primary prevention was still low in the pediatric population in Korea, but there was a substantial rate of appropriate shock in these patients. Efforts to increase ICD usage to save the lives of high-risk patients and reduce the incidence of inappropriate shock are required.
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A 2021 study conducted a cohort in High risk of sudden cardiac death (n=99). Implantable cardioverter-defibrillator (ICD) was evaluated on Appropriate shock. In a Korean multicenter cohort of 99 pediatric patients, implantable cardioverter-defibrillators delivered appropriate shocks in 44% of patients and inappropriate shocks in 33% over a mean follow-up of 4.9 years.
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