Subcutaneous Implantable Cardioverter-Defibrillators in Pediatrics and Congenital Heart Disease: A Pediatric and Congenital Electrophysiology Society Multicenter Review

dc.contributor.authorvon Alvensleben, Johannes C.
dc.contributor.authorDechert, Brynn
dc.contributor.authorBradley, David J.
dc.contributor.authorFish, Frank A.
dc.contributor.authorMoore, Jeremy P.
dc.contributor.authorPilcher, Thomas A.
dc.contributor.authorEscudero, Carolina
dc.contributor.authorCeresnak, Scott R.
dc.contributor.authorKwok, Sit Yee
dc.contributor.authorBalaji, Seshadri
dc.contributor.authorAziz, Peter F.
dc.contributor.authorPapagiannis, John
dc.contributor.authorCortez, Daniel
dc.contributor.authorGarnreiter, Jason
dc.contributor.authorKean, Adam
dc.contributor.authorSchäfer, Michal
dc.contributor.authorCollins, Kathryn K.
dc.contributor.departmentPediatrics, School of Medicineen_US
dc.date.accessioned2022-02-16T21:20:20Z
dc.date.available2022-02-16T21:20:20Z
dc.date.issued2020-12
dc.description.abstractObjectives The primary goal of this study was to evaluate the implant experience and midterm results of subcutaneous implantable cardioverter-defibrillators (S-ICDs) in pediatric patients and those with congenital heart disease. Background The S-ICD was developed to avoid the lead-related complications associated with transvenous systems. The absence of intravascular or intracardiac components offers potential advantages to pediatric patients and those with congenital heart disease. Methods This international, multicenter, retrospective, standard-of-care study was conducted through the Pediatric & Congenital Electrophysiology Society. Complications at 30 and 360 days, inappropriate shocks, and delivery of appropriate therapy were assessed. Results The study included 115 patients with a median follow-up of 32 (19 to 52) months. Median age was 16.7 years (14.8 to 19.3 years), 29% were female, and 55% had a primary prevention indication. Underlying disease substrate was cardiomyopathy (40%), structural heart disease (32%), idiopathic ventricular fibrillation (16%), and channelopathy (13%). The complication rate was 7.8% at 30 days and 14.7% at 360 days. Overall, inappropriate shocks occurred in 15.6% of patients, with no single clinical characteristic reaching statistical significance. At implant, 97.9% of patients had successful first shock conversion with 96% requiring ≤65 J. Appropriate therapy was delivered to 11.2% of patients with an annual incidence of 3.9% and an acute first shock conversion success rate of 92.5%. Conclusions This study found that in a heterogeneous population of pediatric patients and those with congenital heart disease, the S-ICD had comparable rates of complications, inappropriate shocks, and conversion efficacy compared with previously published studies on transvenous systems in similar populations.en_US
dc.eprint.versionFinal published versionen_US
dc.identifier.citationvon Alvensleben, J. C., Dechert, B., Bradley, D. J., Fish, F. A., Moore, J. P., Pilcher, T. A., ... & Collins, K. K. (2020). Subcutaneous implantable cardioverter-defibrillators in pediatrics and congenital heart disease: a pediatric and congenital electrophysiology society multicenter review. Clinical Electrophysiology, 6(14), 1752-1761. https://doi.org/10.1016/j.jacep.2020.07.010en_US
dc.identifier.urihttps://hdl.handle.net/1805/27831
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.isversionof10.1016/j.jacep.2020.07.010en_US
dc.relation.journalClinical Electrophysiologyen_US
dc.sourcePublisheren_US
dc.subjectadult congenital heart diseaseen_US
dc.subjectelectrophysiologyen_US
dc.subjectpediatricsen_US
dc.titleSubcutaneous Implantable Cardioverter-Defibrillators in Pediatrics and Congenital Heart Disease: A Pediatric and Congenital Electrophysiology Society Multicenter Reviewen_US
dc.typeArticleen_US
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