High incidence of appropriate and inappropriate ICD therapies in children and adolescents with implantable cardioverter defibrillator.
Appropriate and inappropriate therapies of implantable cardioverter defibrillators have a major impact on morbidity and quality of life in ICD recipients, but have not been systematically studied in children and young adults during long-term follow-up. ICD implantation was performed in 20 patients a...
| Published in: | Pacing & Clinical Electrophysiology Vol. 27; no. 7; pp. 924 - 933 |
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| Main Authors: | , , , , |
| Format: | diagnostic images pictorial research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Jul2004
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106473734&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106473734 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jul2004 vid: 27 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106473734 106473734 2005099648 10.1111/j.1540-8159.2004.00560.x NLM15271011 106473734 ppf: 924 ppct: 9 formats: fmt: @attributes: type: P tig: atl: High incidence of appropriate and inappropriate ICD therapies in children and adolescents with implantable cardioverter defibrillator. aug: au: Korte T Köditz H Niehaus M Paul T Tebbenjohanns J affil: Department of Cardiology and Angiology, Medical School Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; korte.thomas@mh-hannover.de sug: subj: Cardioversion Defibrillators, Implantable Tachycardia, Ventricular Risk Factors Ventricular Fibrillation Risk Factors Adolescence Adult Child Data Analysis, Statistical Descriptive Statistics Germany Incidence Prospective Studies Human Adolescent: 13-18 years Adult: 19-44 years Child: 6-12 years ab: Appropriate and inappropriate therapies of implantable cardioverter defibrillators have a major impact on morbidity and quality of life in ICD recipients, but have not been systematically studied in children and young adults during long-term follow-up. ICD implantation was performed in 20 patients at the mean age of 16 +/- 6 years, 11 of which had prior surgical repair of a congenital heart defect, 9 patients had other cardiac diseases. Implant indications were aborted sudden cardiac death in six patients, recurrent ventricular tachycardia in 9 patient, and syncope in 5 patients. Epicardial implantation was performed in 6 and transvenous implantation in 14 patients. Incidence, reasons and predictors (age, gender, repaired congenital heart disease, history of supraventricular tachycardia, and epicardial electrode system) of appropriate and inappropriate ICD therapies were analyzed during a mean follow-up period of 51 +/- 31 months range 18-132 months. There were a total 239 ICD therapies in 17 patients (85%) with a therapy rate of 2.8 per patient-years of follow-up. 127 (53%) ICD therapies in 15 (75%) patients were catagorized as appropriate and 112 (47%) therapies in 10 (50%) patients as inappropriate, with a rate of 1.5 appropriate and 1.3 inappropriate ICD therapies per patient-years of follow-up. Time to first appropriate therapy was 16 +/- 18 months. Appropriate therapies were caused by ventricular fibrillation in 29 and ventricular tachycardia in 98 episodes. Termination was successful by antitachycardia pacing in 4 (3%) and by shock therapy in 123 episodes (97%). Time to first inappropriate therapy was 16 +/- 17 months. Inappropriate therapies were caused by supraventricular tachycardia in 77 (69%), T wave oversensing in 19 (17%), and electrode defect in 16 episodes (14%). It caused shocks in 87 (78%) and only antitachycardia pacing in 25 episodes (22%). No clinical variable could be identified as predictor of either appropriate or inappropriate ICD therapies. There is a high rate of ICD therapies in young ICD recipients, the majority of which occur during early follow-up. The rate of inappropriate therapies is as high as 47% and is caused by supraventricular tachycardia and electrode complications in the majority of cases. Prospective trials are required to establish preventative strategies of ICD therapies in this young patient population. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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