open access

Vol 78, No 9 (2020)
Original article
Published online: 2020-07-02
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Children and young adults treated with transvenous and subcutaneous implantable cardioverter-defibrillators: a 22-year single-center experience and new perspectives

Michał Lewandowski, Paweł Syska, Ilona Kowalik
DOI: 10.33963/KP.15469
·
Pubmed: 32631024
·
Kardiol Pol 2020;78(9):869-874.

open access

Vol 78, No 9 (2020)
Original article
Published online: 2020-07-02

Abstract

Background: Over the last several years the evolution of transvenous implantable cardioverter‑defibrillator (T‑ICD) system and the introduction of subcutaneous ICD (S‑ICD) have contributed to the development of the sudden cardiac death (SCD) prevention in clinical practice.

Aims: To report our clinical experience with ICD therapy in children and young adults during the twenty‑ ‑two years of the follow‑up.

Methods: We reviewed the database of ICD recipients choosing 80 consecutive patients (pts) implanted at the age of 6–21 in 1996–2018. We analyzed the rate of appropriate (AT) and inappropriate therapies (IT), mortality, complications and new treatment options.

Results: A total of 21/80 patients (26.25%) received ≥1 AT for ventricular tachycardia/ventricular fibrillation (anti‑tachycardia pacing or shock) and 25/80 patients (31.25%) had one or multiple IT (P = 0.47). Nine patients (11%) had both AT and IT interventions. During follow‑up, 2 (2.5%) cardiac resynchronization therapy (CRT) systems, and 8 (10%) S‑ICDs were implanted, 3 heart transplantations were performed, and 1 severe tricuspid valve regurgitation occurred. A total of 6/80 patients (7.5%) died. All deaths occurred in the hypertrophic cardiomyopathy group.

Conclusions: The mortality rate was 6/80 (7.5%) in the twenty‑two‑year follow‑up. The rate of AT vs. IT was almost equal and remained steady in the long observation period. Severe TR might be a serious clinical problem in some patients. Entirely S‑ICD for SCD prevention is a feasible and safe therapy in young recipients.

Abstract

Background: Over the last several years the evolution of transvenous implantable cardioverter‑defibrillator (T‑ICD) system and the introduction of subcutaneous ICD (S‑ICD) have contributed to the development of the sudden cardiac death (SCD) prevention in clinical practice.

Aims: To report our clinical experience with ICD therapy in children and young adults during the twenty‑ ‑two years of the follow‑up.

Methods: We reviewed the database of ICD recipients choosing 80 consecutive patients (pts) implanted at the age of 6–21 in 1996–2018. We analyzed the rate of appropriate (AT) and inappropriate therapies (IT), mortality, complications and new treatment options.

Results: A total of 21/80 patients (26.25%) received ≥1 AT for ventricular tachycardia/ventricular fibrillation (anti‑tachycardia pacing or shock) and 25/80 patients (31.25%) had one or multiple IT (P = 0.47). Nine patients (11%) had both AT and IT interventions. During follow‑up, 2 (2.5%) cardiac resynchronization therapy (CRT) systems, and 8 (10%) S‑ICDs were implanted, 3 heart transplantations were performed, and 1 severe tricuspid valve regurgitation occurred. A total of 6/80 patients (7.5%) died. All deaths occurred in the hypertrophic cardiomyopathy group.

Conclusions: The mortality rate was 6/80 (7.5%) in the twenty‑two‑year follow‑up. The rate of AT vs. IT was almost equal and remained steady in the long observation period. Severe TR might be a serious clinical problem in some patients. Entirely S‑ICD for SCD prevention is a feasible and safe therapy in young recipients.

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About this article
Title

Children and young adults treated with transvenous and subcutaneous implantable cardioverter-defibrillators: a 22-year single-center experience and new perspectives

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 78, No 9 (2020)

Article type

Original article

Pages

869-874

Published online

2020-07-02

Page views

293

Article views/downloads

245

DOI

10.33963/KP.15469

Pubmed

32631024

Bibliographic record

Kardiol Pol 2020;78(9):869-874.

Authors

Michał Lewandowski
Paweł Syska
Ilona Kowalik

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