Titre
Epicardial and pleural lead ICD systems in children and adolescents maintain functionality over 5 years.
Type
article
Institution
Externe
Périodique
Auteur(s)
Tomaske, M.
Auteure/Auteur
Prêtre, R.
Auteure/Auteur
Rahn, M.
Auteure/Auteur
Bauersfeld, U.
Auteure/Auteur
Liens vers les personnes
ISSN
1532-2092
Statut éditorial
Publié
Date de publication
2008
Volume
10
Numéro
10
Première page
1152
Dernière page/numéro d’article
1156
Peer-reviewed
Oui
Langue
anglais
Résumé
AIMS: The optimal implantable cardioverter defibrillator (ICD) system implant technique has not yet been defined in young patients and those with congenital heart disease (CHD). We describe our 5-year experience with epicardial pacing/sensing leads secured on the left cardiac chambers and a pleural defibrillation lead insertion along the third intercostal space.
METHODS AND RESULTS: Implantable cardioverter defibrillator systems were implanted in 15 children and adolescents (age: 2.9-20.0 years) for primary (n = 11) or secondary (n = 4) prevention. Underlying CHD were hypertrophic (n = 10) or dilative cardiomyopathies (n = 2), primary electrical diseases (n = 2), and transposition of the great arteries (n = 1). Devices were placed in the rectus sheath (n = 5), or within the diaphragm (n = 10). Median defibrillation threshold at implant was 15 J (range: 10-25). During 5 years of follow-up (median: 22 months), nine appropriate and two inappropriate ICD discharges occurred. Four system revisions were required due to device recall, pleural lead dislodgement, epicardial lead fracture, and insulation break. Twelve months after the implantation, defibrillation threshold testing demonstrated stable thresholds of <or=20 J in five patients.
CONCLUSION: Our 5-year experience demonstrates the efficacy of epicardial and pleural lead ICD systems. Inappropriate shocks and lead failures are observed as in other ICD systems. It represents an alternative implant technique for young and active patients and those without venous access.
METHODS AND RESULTS: Implantable cardioverter defibrillator systems were implanted in 15 children and adolescents (age: 2.9-20.0 years) for primary (n = 11) or secondary (n = 4) prevention. Underlying CHD were hypertrophic (n = 10) or dilative cardiomyopathies (n = 2), primary electrical diseases (n = 2), and transposition of the great arteries (n = 1). Devices were placed in the rectus sheath (n = 5), or within the diaphragm (n = 10). Median defibrillation threshold at implant was 15 J (range: 10-25). During 5 years of follow-up (median: 22 months), nine appropriate and two inappropriate ICD discharges occurred. Four system revisions were required due to device recall, pleural lead dislodgement, epicardial lead fracture, and insulation break. Twelve months after the implantation, defibrillation threshold testing demonstrated stable thresholds of <or=20 J in five patients.
CONCLUSION: Our 5-year experience demonstrates the efficacy of epicardial and pleural lead ICD systems. Inappropriate shocks and lead failures are observed as in other ICD systems. It represents an alternative implant technique for young and active patients and those without venous access.
PID Serval
serval:BIB_66FBB6751F8C
PMID
Open Access
Oui
Date de création
2014-12-16T18:18:17.700Z
Date de création dans IRIS
2025-05-21T04:29:35Z