Midterm Efficacy of SubcutAneous Implantable CardioVErter-Defibrillator in ≤ 18 Year-Old CHILDREN (SAVE CHILDREN-II Registry).
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Mori Hitoshi, Nabeshima Taisuke, Nagaoka Kota, Fukunaga Hideo, Hayashi Hidemori, Inaba Osamu, Isonaga Yuhei, Asano So, Nitta Junichi, Watanabe Shigeo, Otsuki Sou, Suzuki Hiroshi, Fukaya Hidehira, Kishihara Jun, Chisaka Toshiyuki, Higaki Takashi, Okada Ayako, Kobayashi Hideki, Sekihara Takayuki, Oka Takafumi, Sato Seiichi, Yoshino Keisuke, Kondo Hidekazu, Takahashi Naohiko, Kato Ken, Miura Masaru, Maeda Jun, Tamura Shuntaro, Ikeda Kentaro, Goto Hiroko, Murakami Takashi, Wada Tsutomu, Takamuro Motoki, Suzuki Tsugutoshi, Ishida Yuji, Sasaki Shingo, Nishimura Takuro, Takigawa Masateru, Matsuura Tomomi, Imamura Tomohiko, Shizuta Satoshi, Fukunaga Masato, Kuroda Maiko, Hojo Rintaro, Fukamizu Seiji, Suzuki Hirohiko, Yoshida Yukihiko, Morishima Itsuro, Kuraishi Kenji, Nishihara Eiki, Naruse Yoshihisa, Sato Tomoyuki, Aizawa Yoshiyasu, Nishizaki Kimitaka, Nakamura Kentaro, Nuruki Norihito, Yoshinaga Masao, Ikeya Yukitoshi, Okumura Yasuo, Muraji Shota, Kondo Yusuke, Nakano Makoto, Kito Machiko, Inden Yasuya, Higuchi Satoshi, Kinjo Takahiko, Matsumoto Kazuhisa, Narita Masataka, Sasaki Wataru, Naganuma Tsukasa, Kawano Daisuke, Tanaka Naomichi, Matsumoto Kei, Kojima Takuro, Ikeda Yoshifumi, Kato Ritsushi, Sumitomo Naokata
Аннотация
METHODS: This multicenter, retrospective observational study included pediatric patients (≤ 18 years) who underwent S-ICD implantation between February 2016 and July 2021. Clinical characteristics, pre-implant screening, procedural details, device-related events, and follow-up data were analyzed. The incidence and management of appropriate and inappropriate therapies and subsequent recurrence were evaluated.
RESULTS: Ninety-six patients (median age 14.5 years) were enrolled and followed for a median of 70 months (29-75.0 months). Sensing vector suitability remained stable despite somatic growth. Appropriate shocks occurred in 32 patients (33.7%), while inappropriate shocks occurred in 27 (28.4%). After appropriate therapy, intensified pharmacological treatment and catheter ablation prevented recurrent device therapy in 45.5% and 50.0% of cases, respectively, although device shock occurred in 50.9% despite intervention. Following inappropriate therapy, device reprogramming and lifestyle guidance prevented recurrence in 71.4% of patients (15/21). Device-related infection was rare (2 cases), and no lead fractures were observed.
CONCLUSIONS: S-ICD therapy demonstrated favorable mid-term safety and efficacy in pediatric patients, with durable sensing performance and a low incidence of device-related infection. Although inappropriate shocks were not uncommon, appropriate post-shock management effectively reduced recurrence, supporting S-ICD as a viable option for selected pediatric patients without pacing requirements.