Pacing and clinical electrophysiology : PACE · 2010
ICD therapy in children and young adults: low incidence of inappropriate shock delivery.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Botsch Micha P, Franzbach Birgit, Opgen-Rhein Bernd, Berger Felix, Will Joachim C
Аннотация
INTRODUCTION: Implantable cardioverter defibrillator (ICD) therapy of life-threatening arrhythmias in pediatric patients is feasible; however, recent studies report a high incidence of inappropriate shock deliveries.
METHODS: The data of all recipients of an ICD at the Charité, Department of Pediatric Cardiology, between January 2001 and November 2007 were retrospectively analyzed regarding underlying cardiac disorders, arrhythmias, medication, ablation procedures, leads and devices, programming, and ICD therapies.
RESULTS: A total of 33 patients underwent ICD implantation, with a median age of 16.5 years (range 8-36 years) and a mean weight of 61 +/- 20.9 kg. Underlying cardiac disorders were electrical heart disease (27%), cardiomyopathy (30%), congenital heart disease (33%), and others (9%). Eighty-five percent received antiarrhythmic drugs, and 12 ablation procedures were performed in nine patients (27%). The devices were programmed individually according to the underlying diseases and arrhythmias. During follow-up, a total of 63 shock therapies were delivered in 11 patients, while a majority of 34 shocks occurred in one patient (no therapies in 22 of 33 patients). Only two such therapies were inappropriate, both delivered for atrial flutter.
CONCLUSIONS: In children and young adults receiving ICD therapy, the combination of strategies to prevent ventricular arrhythmias using specific drug therapy, ablation procedures, and individual programming with improved devices and leads causes a low incidence of inappropriate shock delivery.
METHODS: The data of all recipients of an ICD at the Charité, Department of Pediatric Cardiology, between January 2001 and November 2007 were retrospectively analyzed regarding underlying cardiac disorders, arrhythmias, medication, ablation procedures, leads and devices, programming, and ICD therapies.
RESULTS: A total of 33 patients underwent ICD implantation, with a median age of 16.5 years (range 8-36 years) and a mean weight of 61 +/- 20.9 kg. Underlying cardiac disorders were electrical heart disease (27%), cardiomyopathy (30%), congenital heart disease (33%), and others (9%). Eighty-five percent received antiarrhythmic drugs, and 12 ablation procedures were performed in nine patients (27%). The devices were programmed individually according to the underlying diseases and arrhythmias. During follow-up, a total of 63 shock therapies were delivered in 11 patients, while a majority of 34 shocks occurred in one patient (no therapies in 22 of 33 patients). Only two such therapies were inappropriate, both delivered for atrial flutter.
CONCLUSIONS: In children and young adults receiving ICD therapy, the combination of strategies to prevent ventricular arrhythmias using specific drug therapy, ablation procedures, and individual programming with improved devices and leads causes a low incidence of inappropriate shock delivery.