From Selective Parasympathetic Modulation of AV Node to Rate Control Therapy

Stephenson, Elizabeth A.; Batra, Anjan S.; Knilans, Timothy K.; Gow, Robert M.; Gradaus, Rainer; Balaji, Seshadri; Dubin, Anne M.; Rhee, Edward K.; Ro, Pamela S.; Thøgersen, Anna Margrethe; Cecchin, Frank; Triedman, John K.; Walsh, Edward P.; Berul, Charles I.

doi:10.1111/j.1540-8167.2005.00271.x

Cited by 210 publications

(100 citation statements)

References 36 publications

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“…However, pediatric ICD therapy, in addition to being limited by the small size of infants, may also be associated with complications such as infection of the device system, lead dislodgement and fracture, and a relatively higher rate of inappropriate shocks than in adults. In our patient, we used a novel technique for ICD implantation in infants as reported by Stephenson et al [13]. The ICD generator is placed in the abdomen and a subcutaneous finger array or patch electrode is positioned in the left thorax.…”

Section: Discussionmentioning

confidence: 97%

Implantable cardioverter defibrillator as a bridge to recovery in an infant with cardiac rhabdomyoma

et al. 2008

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Multiple cardiac rhabdomyomas in an infant presented with recurrent life-threatening ventricular arrhythmias refractory to medical treatment and necessitating the placement of an implantable cardioverter defibrillator (ICD). The device functioned effectively as a bridge to recovery during a 2-year follow-up period, when the tumor showed spontaneous regression, along with an almost complete resolution of the ventricular arrhythmias. We conclude that childhood cardiac rhabdomyomas causing severe drug-refractory ventricular arrhythmias can be managed by ICD therapy.

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Section: Discussionmentioning

confidence: 97%

Implantable cardioverter defibrillator as a bridge to recovery in an infant with cardiac rhabdomyoma

et al. 2008

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“…Thogersen et al (8) used a transvenous lead subcutaneously for extracardiac defibrillator implantation, and different configurations with the various number of leads and/or active can has been introduced by different authors. These configurations have included subcutaneous arrays and transvenous coils placed epicardially or subcutaneously and the infracardiac positioning of the active can (9, 10). …”

Section: Discussionmentioning

confidence: 99%

“…These problems were commonly observed during the linear growth of patients. Lead failure or migration requiring system revision has been reported as 18% for subcutaneous/epicardial leads (9). Pericardial coils have been reported with a high incidence of inappropriate shocks compared with subcutaneous systems.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous defibrillator implantation in pediatric patients

et al. 2015

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Objective:Although sudden cardiac death is rare in children, an intracardiac defibrillator system is indicated in children with various types of cardiomyopathy, primary electrical diseases, and after surgical repair of congenital heart defects. The use of transvenous defibrillator lead systems is limited in pediatric patients because of a small body size and/or limited vascular access. Subcutaneous array leads combined with an abdominally placed generator can enable implantation.Method:This is a retrospective study of 13 patients who underwent subcutaneous defibrillator implantation between September 2010 and March 2015. The subcutaneous system was preferred because patients were not amenable to transvenous lead placement.Results:The median patient age was 4.1 years, and the median patient weight was 12.1 kg. Diagnoses of patients were long-QT syndrome in 6, aborted cardiac arrest with left ventricular non-compaction in 3, hypertrophic cardiomyopathy with sustained ventricular tachycardia in 3, and arrythmogenic right ventricular cardiomyopathy in 1. Revision of the subcutaneous lead was required in 5 patients 2–26 months after the implantation. Appropriate shocks were observed in three patients. Inappropriate shock and lead fractures were observed in one patient during the follow-up period. The failure of therapy was observed in one patient. There were no perioperative complications and no early or late deaths.Conclusion:Subcutaneous defibrillator systems are safe and effective in pediatric patients when the transvenous method is risky and contraindicated. Because the high growth rate in this population leads to lead failures, a close follow-up of this population is essential. (Anatol J Cardiol 2016; 16: 630-4)

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“…14 The results of this registry suggested reasonable sensing discrimination, but the study was limited by a lack of detail regarding surgical palliation and an absence of tachyarrhythmia events during by guest on May 11, 2018 http://circep.ahajournals.org/ Downloaded from S-ICD in Congenital Heart Disease follow up. Given the significant heterogeneity of the congenital heart population in terms of cardiac morphology, distribution of ventricular mass, and known variable response to defibrillation, 15,16 further detailed analysis of this new technology is needed. Important findings of this study include the following: (1) the 2 most frequent indications for S-ICD placement in this ACHD population were absence of a systemic venous connection to the heart because of prior surgery and the presence of residual intracardiac shunt, (2) reliable detection and conversion of induced ventricular arrhythmia with the S-ICD can be achieved despite heterogeneous anatomy, and (3) rhythm discrimination seems to be acceptable up to 1-year postimplant.…”

Section: Discussionmentioning

confidence: 99%

“…A variety of techniques have been proposed to implant defibrillation systems in this patient group, all involving either a sternotomy for epicardial placement or hybrid transvenous/epicardial approach. 7,15 Limitations of these strategies include the need for frequent system revisions, inadequate or evolving defibrillation thresholds over time, and system failure, particularly, with epicardial patches. Given that the single ventricle population contributes significantly to the burden of SCD in the ACHD community 2 yet represents only a small fraction of total ICD implants, 10 this group seems to be underrepresented with respect to SCD prevention.…”

Section: Discussionmentioning

confidence: 99%

Clinical Experience With the Subcutaneous Implantable Cardioverter–Defibrillator in Adults With Congenital Heart Disease

Moore

Mondésert

Lloyd

et al. 2016

Circ: Arrhythmia and Electrophysiology

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Background-Sudden cardiac death is a major contributor to mortality for adults with congenital heart disease. The subcutaneous implantable cardioverter-defibrillator (ICD) has emerged as a novel tool for prevention of sudden cardiac death, but clinical performance data for adults with congenital heart disease are limited. Methods and Results-A retrospective study involving 7 centers over a 5-year period beginning in 2011 was performed.Twenty-one patients (median 33.9 years) were identified. The most common diagnosis was single ventricle physiology (52%), 9 palliated by Fontan operation and 2 by aortopulmonary shunts: d-transposition of the great arteries after Mustard/Senning (n=2), tetralogy of Fallot (n=2), aortic valve disease (n=2), and other biventricular surgery (n=4). A prior cardiac device had been implanted in 7 (33%). The ICD indication was primary prevention in 67% and secondary in 33% patients. The most common reason for subcutaneous ICD placement was limited transvenous access for ventricular lead placement (n=10) followed by intracardiac right-to-left shunt (n=5). Ventricular arrhythmia was induced in 17 (81%) and was converted with ≤80 Joules in all. There was one implant complication related to infection, not requiring device removal. Over a median follow-up of 14 months, 4 patients (21%) received inappropriate and 1 (5%) patient received appropriate shocks. There was one arrhythmic death related to asystole in a single ventricle patient. Conclusions-Subcutaneous ICD implantation is feasible for adults with congenital heart disease patients. Most candidates have single ventricle heart disease and limited transvenous options for ICD placement. Despite variable anatomy, this study demonstrates successful conversion of induced ventricular arrhythmia and reasonable rhythm discrimination during follow-up. (Circ Arrhythm Electrophysiol. 2016;9:e004338.

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From Selective Parasympathetic Modulation of AV Node to Rate Control Therapy

Cited by 210 publications

References 36 publications

Implantable cardioverter defibrillator as a bridge to recovery in an infant with cardiac rhabdomyoma

Implantable cardioverter defibrillator as a bridge to recovery in an infant with cardiac rhabdomyoma

Subcutaneous defibrillator implantation in pediatric patients

Clinical Experience With the Subcutaneous Implantable Cardioverter–Defibrillator in Adults With Congenital Heart Disease

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