The use of implantable cardioverter defibrillators in pediatrics

Abstract

BACKGROUND: Up to 1 in 2000 children suffer a cardiac genetic disease, the main indication to use an implantable cardioverter defibrillation. There is a wide spectrum of clinical presentation: from asymptomatic to sudden cardiac death as first manifestation of the disease. Implantable cardiac defibrillator (ICD) is one of the tools to preventsudden cardiac death.

HYPOTHESIS AND OBJECTIVES: The hypothesis is that ICD is a useful tool for pediatric patients affected by a cardiac genetic disease. The aim of this project was to analyze demographic data and clinical characteristics of the patients and describe the usefulness of ICD.

METHODS: A descriptive, cross-sectional, observational, and retrospective study was designed to study the pediatric population carrying and ICD in a pediatric referral center.

RESULTS: A total of 79 pediatric patients carrying ICD were analyzed; 37.7% had channelopathies and 55.8% had a cardiomyopathy. In 48.1% the ICD was implanted as secondary prevention. In 59.6% patients, there was a family history an inherited cardiac disease prior to the implant. In 63.16%, the patient was the index case. Taking into consideration the etiology, there were no differences concerning gender and age. When considering indication, secondary prevention was statistically significant more frequent in older children. Finally, 20 patients had potentially lethal arrhythmias that were correctly detected and treated by the ICD.

CONCLUSIONS: our results show that ICD seems to be a useful tool for malign arrhythmias treatment in pediatric patients with cardiac genetic disease, both in primary or secondary prevention