Role of transvenous Implantable cardioverter-defibrillators in preventing sudden cardiac death in children, adolescents, and young adults

被引:52
作者
Chatrath, R
Porter, CBJ
Ackerman, MJ
机构
[1] Mayo Eugenio Litta Childrens Hosp, Div Pediat Cardiol, Rochester, MN USA
[2] Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Rochester, MN 55905 USA
关键词
D O I
10.4065/77.3.226
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To evaluate the indications, underlying cardiac disorders, efficacy, and complications involved with transvenous implantable cardioverter-defibrillators (ICDs) in pediatric patients at the Mayo Clinic. Patients and Methods: The records of all patients aged 21 years or younger who underwent transvenous ICD placement at the Mayo Clinic, Rochester, Minn, were reviewed retrospectively. Results: Between March 1992 and September 2000,16 patients (7 females; mean age, 15.4 years; range, 10-21 years) underwent transvenous ICD placement. The ICD was implanted for primary prevention of sudden cardiac death in 7 and for secondary prevention in 9. The underlying cardiac disorders included hypertrophic cardiomyopathy in 6 patients and congenital long QT syndrome in 6 patients. The mean +/- SD follow-up was 36+/-29 months (range, 5-108 months). There was no mortality. Seven patients (44%) received appropriate ICD therapy, including 6 of 9 who had ICDs placed for secondary prevention. Median time free from appropriate ICD discharge was 3 years (range, 0.2-9 years). Three patients (19%) experienced inappropriate ICD discharge. Two patients needed device replacement because of technical problems (lead fracture and device malfunction). Two patients developed pocket infection that required removal and reimplantation of the ICD. Conclusion: In adolescents and young adults, transvenous ICDs may prevent sudden death but are not free of complications. Forty-four percent of this cohort received potentially life-saving ICD therapy, Including two thirds who received an ICD for secondary prevention.
引用
收藏
页码:226 / 231
页数:6
相关论文
共 23 条
[1]   The long QT syndrome: Ion channel diseases of the heart [J].
Ackerman, MJ .
MAYO CLINIC PROCEEDINGS, 1998, 73 (03) :250-269
[2]   Arrhythmogenic right ventricular cardiomyopathy: diagnosis, prognosis, and treatment [J].
Corrado, D ;
Basso, C ;
Thiene, G .
HEART, 2000, 83 (05) :588-595
[3]   Long-term follow-up of patients with long-QT syndrome treated with β-blockers and continuous pacing [J].
Dorostkar, PC ;
Eldar, M ;
Belhassen, B ;
Scheinman, MM .
CIRCULATION, 1999, 100 (24) :2431-2436
[4]   ELECTROPHYSIOLOGICAL LABORATORY, ELECTROPHYSIOLOGIST-IMPLANTED, NONTHORACOTOMY-IMPLANTABLE CARDIOVERTER/DEFIBRILLATORS [J].
FITZPATRICK, AP ;
LESH, MD ;
EPSTEIN, LM ;
LEE, RJ ;
SIU, A ;
MERRICK, S ;
GRIFFIN, JC ;
SCHEINMAN, MM .
CIRCULATION, 1994, 89 (06) :2503-2508
[5]   THE LONG QT SYNDROME IN CHILDREN - AN INTERNATIONAL STUDY OF 287 PATIENTS [J].
GARSON, A ;
DICK, M ;
FOURNIER, A ;
GILLETTE, PC ;
HAMILTON, R ;
KUGLER, JD ;
VANHARE, GF ;
VETTER, V ;
VICK, GW .
CIRCULATION, 1993, 87 (06) :1866-1872
[6]   The implantable cardioverter defibrillator [J].
Glikson, M ;
Friedman, PA .
LANCET, 2001, 357 (9262) :1107-1117
[7]   Use of implantable cardioverter-defibrillators in the congenital long QT syndrome [J].
Groh, WJ ;
Silka, MJ ;
Oliver, RP ;
Halperin, BD ;
McAnulty, JH ;
Kron, J .
AMERICAN JOURNAL OF CARDIOLOGY, 1996, 78 (06) :703-706
[8]   Five-year experience with implantable defibrillators in children [J].
Hamilton, RM ;
Dorian, P ;
Gow, RM ;
Williams, WG .
AMERICAN JOURNAL OF CARDIOLOGY, 1996, 77 (07) :524-&
[9]   Initial clinical experience with a new down-sized implantable cardioverter-defibrillator [J].
Klein, H ;
Auricchio, A ;
Huvelle, E ;
Nisam, S .
AMERICAN JOURNAL OF CARDIOLOGY, 1996, 78 :9-14
[10]   PRELIMINARY EXPERIENCE WITH NONTHORACOTOMY IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS IN YOUNG-PATIENTS [J].
KRON, J ;
SILKA, MJ ;
OHM, OJ ;
BARDY, G ;
BENDITT, D ;
CHILSON, D ;
GILLIS, AM ;
MITCHELL, LB ;
GULAMHUSEIN, S ;
KUCK, K ;
SIEBELS, J ;
BREITHARDT, G ;
BLOCK, M ;
TOUBOUL, P ;
PRADEL, L ;
BRACHMANN, J ;
RUSKIN, J ;
HAFFAJEE, C .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1994, 17 (01) :26-30