ICD Outcome in Pediatric Cardiomyopathies

Silvetti, Massimo Stefano; Tamburri, Ilaria; Campisi, Marta; Saputo, Fabio Anselmo; Cazzoli, Ilaria; Cantarutti, Nicoletta; Cicenia, Marianna; Adorisio, Rachele; Baban, Anwar; Ravà, Lucilla; Drago, Fabrizio

doi:10.3390/jcdd9020033

Cited by 4 publications

(3 citation statements)

References 43 publications

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“…Few studies compared the outcomes of S-ICD and transvenous ICD. There were no significant differences in the efficacy of both systems [128], while S-ICD showed less frequent lead-related complications and inappropriate shocks and more frequent pocket-related complications [129].…”

Section: Discussionmentioning

confidence: 86%

New Guidelines of Pediatric Cardiac Implantable Electronic Devices: What Is Changing in Clinical Practice?

Silvetti,

Colonna,

Gabbarini

et al. 2024

JCDD

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Guidelines are important tools to guide the diagnosis and treatment of patients to improve the decision-making process of health professionals. They are periodically updated according to new evidence. Four new Guidelines in 2021, 2022 and 2023 referred to pediatric pacing and defibrillation. There are some relevant changes in permanent pacing. In patients with atrioventricular block, the heart rate limit in which pacemaker implantation is recommended was decreased to reduce too-early device implantation. However, it was underlined that the heart rate criterion is not absolute, as signs or symptoms of hemodynamically not tolerated bradycardia may even occur at higher rates. In sinus node dysfunction, symptomatic bradycardia is the most relevant recommendation for pacing. Physiological pacing is increasingly used and recommended when the amount of ventricular pacing is presumed to be high. New recommendations suggest that loop recorders may guide the management of inherited arrhythmia syndromes and may be useful for severe but not frequent palpitations. Regarding defibrillator implantation, the main changes are in primary prevention recommendations. In hypertrophic cardiomyopathy, pediatric risk calculators have been included in the Guidelines. In dilated cardiomyopathy, due to the rarity of sudden cardiac death in pediatric age, low ejection fraction criteria were demoted to class II. In long QT syndrome, new criteria included severely prolonged QTc with different limits according to genotype, and some specific mutations. In arrhythmogenic cardiomyopathy, hemodynamically tolerated ventricular tachycardia and arrhythmic syncope were downgraded to class II recommendation. In conclusion, these new Guidelines aim to assess all aspects of cardiac implantable electronic devices and improve treatment strategies.

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Section: Discussionmentioning

confidence: 86%

New Guidelines of Pediatric Cardiac Implantable Electronic Devices: What Is Changing in Clinical Practice?

Silvetti,

Colonna,

Gabbarini

et al. 2024

JCDD

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“…A total of five studies [6][7][8][9][10] were identified (Supplementary Figure S2) including 236 patients (Group S-ICD: 76 patients; Group TV-ICD: 160 patients); 53.8% (n = 127) of them were males with an average age of 15.2 ± 6.5 years and weight of 64.6 ± 33.9 kg (Table 1). Overall, 58% (n = 137) of patients were implanted for primary prevention of SCD and the most frequent underlying diagnoses were hypertrophic cardiomyopathy (38.1%), channelopathies (25.9%), dilated cardiomyopathy (14%), idiopathic ventricular fibrillation (10.2%), and arrhythmogenic cardiomyopathy (10.2%) (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Subcutaneous versus transvenous implantable cardioverter defibrillators in children and young adults: A meta‐analysis

Vetta

Parlavecchio

Magnocavallo³

et al. 2022

Pacing Clinical Electrophis

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Introduction:The implantable cardioverter defibrillator (ICD) has been demonstrated to successfully prevent sudden cardiac death (SCD) in children and young adults. A wide range of device-related complications/malfunctions have been described, which depend on the intrinsic design of the defibrillation system (transvenous-implantable cardioverter defibrillator [TV-ICD] vs. subcutaneous-implantable cardioverter defib- rillator [S-ICD]).Objective: To compare the device-related complications and inappropriate shocks with TV-ICD versus S-ICD.Methods and Results: Electronic databases were queried for studies focusing on the prevention of SCD in children and young adults with TV-ICD or S-ICD. The effect size was estimated using a random-effect model as odds ratio (OR) and relative 95% confidence interval (CI). The primary endpoint was a composite of any device-related complications and inappropriate shocks. We identified a total of five studies including 236 patients (Group S-ICD: 76 patients; Group TV-ICD: 160 patients) with a mean follow-up time of 54.2 ± 24.9 months. S-ICD implantation contributed to a significant reduction in the risk of the primary endpoint of any device-related complications and

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“…Dual-chamber ICDs do not demonstrate superiority over single-chamber ICDs in discriminating supraventricular or sinus tachycardia. Lead failure issues are more prevalent in non-transvenous systems compared to transvenous systems, and the simplest ICD systems are associated with the lowest likelihood of lead-related complications [69,148,163].…”

Section: Prevention Of Scdmentioning

confidence: 99%

Inherited Arrhythmias in the Pediatric Population: An Updated Overview

Mariani,

Pierucci,

Fanisio

et al. 2024

Medicina

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Pediatric cardiomyopathies (CMs) and electrical diseases constitute a heterogeneous spectrum of disorders distinguished by structural and electrical abnormalities in the heart muscle, attributed to a genetic variant. They rank among the main causes of morbidity and mortality in the pediatric population, with an annual incidence of 1.1–1.5 per 100,000 in children under the age of 18. The most common conditions are dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM). Despite great enthusiasm for research in this field, studies in this population are still limited, and the management and treatment often follow adult recommendations, which have significantly more data on treatment benefits. Although adult and pediatric cardiac diseases share similar morphological and clinical manifestations, their outcomes significantly differ. This review summarizes the latest evidence on genetics, clinical characteristics, management, and updated outcomes of primary pediatric CMs and electrical diseases, including DCM, HCM, arrhythmogenic right ventricular cardiomyopathy (ARVC), Brugada syndrome (BrS), catecholaminergic polymorphic ventricular tachycardia (CPVT), long QT syndrome (LQTS), and short QT syndrome (SQTS).

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ICD Outcome in Pediatric Cardiomyopathies

Cited by 4 publications

References 43 publications

New Guidelines of Pediatric Cardiac Implantable Electronic Devices: What Is Changing in Clinical Practice?

New Guidelines of Pediatric Cardiac Implantable Electronic Devices: What Is Changing in Clinical Practice?

Subcutaneous versus transvenous implantable cardioverter defibrillators in children and young adults: A meta‐analysis

Inherited Arrhythmias in the Pediatric Population: An Updated Overview

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