Complications and inappropriate shocks in pediatric patients receiving a subcutaneous implantable cardioverter defibrilator
Copyright © 2023. Published by Elsevier España, S.L.U..
INTRODUCTION AND OBJECTIVES: There is limited evidence regarding the use of subcutaneous implantable cardioverter-defibrillators (S-ICD) in pediatric patients. The aim of this study was to determine the incidence of complications in these patients at our center, according to the type of ICD and patient size.
METHODS: We included all patients aged<18 years who received an S-ICD since 2016 at our center. As a control group, we also included contemporary patients (since 2014) who received a transvenous ICD (TV-ICD). The primary endpoint was a composite of complications and inappropriate shocks.
RESULTS: A total of 26 patients received an S-ICD (median age, 14 [5-17] years; body mass index [BMI], 20.2 kg/m2). Implantation was intermuscular in 23 patients (88%) and subserratus in the remainder. Two incisions were used in 24 patients (92%). In all patients, 2 zones were programmed: a conditional zone set at 230 (220-230) bpm, and a shock zone set at 250 bpm. Nineteen patients received a TV-ICD (median age, 11 [range, 5-16] years; BMI, 19.2 kg/m2, 79% single-chamber). Survival free from the primary endpoint at 5 years was 80% in the S-ICD group and 63% in the TV-ICD group (P=.54). Survival free from inappropriate shocks was similar (85% vs 89%, P=.86), while survival free from complications was higher in the S-ICD group (96% vs 57%, cloglog P=.016). There were no therapy failures in the S-ICD group, and no increased complication rates were observed in patients with BMI ≤20 kg/m2.
CONCLUSIONS: With contemporary implantation techniques and programming, S-ICD is a safe and effective therapy in pediatric patients. The number of inappropriate shocks is similar to TV-ICD, with fewer short- and mid-term complications.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
|---|---|
| Enthalten in: |
Revista espanola de cardiologia (English ed.) - (2023) vom: 23. Nov. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Centeno, Miriam [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adult children |
|---|
| Anmerkungen: |
Date Revised 06.12.2023 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1016/j.rec.2023.08.014 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM364918764 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM364918764 | ||
| 003 | DE-627 | ||
| 005 | 20231226100545.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.rec.2023.08.014 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1216.xml |
| 035 | |a (DE-627)NLM364918764 | ||
| 035 | |a (NLM)38000625 | ||
| 035 | |a (PII)S1885-5857(23)00311-0 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Centeno, Miriam |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Complications and inappropriate shocks in pediatric patients receiving a subcutaneous implantable cardioverter defibrilator |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 06.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2023. Published by Elsevier España, S.L.U. | ||
| 520 | |a INTRODUCTION AND OBJECTIVES: There is limited evidence regarding the use of subcutaneous implantable cardioverter-defibrillators (S-ICD) in pediatric patients. The aim of this study was to determine the incidence of complications in these patients at our center, according to the type of ICD and patient size | ||
| 520 | |a METHODS: We included all patients aged<18 years who received an S-ICD since 2016 at our center. As a control group, we also included contemporary patients (since 2014) who received a transvenous ICD (TV-ICD). The primary endpoint was a composite of complications and inappropriate shocks | ||
| 520 | |a RESULTS: A total of 26 patients received an S-ICD (median age, 14 [5-17] years; body mass index [BMI], 20.2 kg/m2). Implantation was intermuscular in 23 patients (88%) and subserratus in the remainder. Two incisions were used in 24 patients (92%). In all patients, 2 zones were programmed: a conditional zone set at 230 (220-230) bpm, and a shock zone set at 250 bpm. Nineteen patients received a TV-ICD (median age, 11 [range, 5-16] years; BMI, 19.2 kg/m2, 79% single-chamber). Survival free from the primary endpoint at 5 years was 80% in the S-ICD group and 63% in the TV-ICD group (P=.54). Survival free from inappropriate shocks was similar (85% vs 89%, P=.86), while survival free from complications was higher in the S-ICD group (96% vs 57%, cloglog P=.016). There were no therapy failures in the S-ICD group, and no increased complication rates were observed in patients with BMI ≤20 kg/m2 | ||
| 520 | |a CONCLUSIONS: With contemporary implantation techniques and programming, S-ICD is a safe and effective therapy in pediatric patients. The number of inappropriate shocks is similar to TV-ICD, with fewer short- and mid-term complications | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adult children | |
| 650 | 4 | |a Child | |
| 650 | 4 | |a DAI subcutáneo | |
| 650 | 4 | |a DAI transvenoso | |
| 650 | 4 | |a Desfibriladores implantables | |
| 650 | 4 | |a Implantable cardioverter defibrillators | |
| 650 | 4 | |a Niño | |
| 650 | 4 | |a Niños adultos | |
| 650 | 4 | |a Subcutaneous-ICD | |
| 650 | 4 | |a Transvenous-ICD | |
| 700 | 1 | |a Álvarez García-Rovés, Reyes |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez-Caballero, Ramón |e verfasserin |4 aut | |
| 700 | 1 | |a Arenal, Ángel |e verfasserin |4 aut | |
| 700 | 1 | |a Atienza, Felipe |e verfasserin |4 aut | |
| 700 | 1 | |a González-Torrecilla, Esteban |e verfasserin |4 aut | |
| 700 | 1 | |a Carta, Alejandro |e verfasserin |4 aut | |
| 700 | 1 | |a Ríos-Muñoz, Gonzalo R |e verfasserin |4 aut | |
| 700 | 1 | |a Medrano, Constancio |e verfasserin |4 aut | |
| 700 | 1 | |a Gil-Jaurena, Juan M |e verfasserin |4 aut | |
| 700 | 1 | |a Fernández-Avilés, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Ávila, Pablo |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Revista espanola de cardiologia (English ed.) |d 2010 |g (2023) vom: 23. Nov. |w (DE-627)NLM206580851 |x 1885-5857 |7 nnns |
| 773 | 1 | 8 | |g year:2023 |g day:23 |g month:11 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.rec.2023.08.014 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2023 |b 23 |c 11 | ||