Implantable Cardioverter Defibrillator Programming Characteristics, Shocked Rhythms, and Survival Among Patients Under Thirty Years of Age

Chang, Philip M.; Powell, Brian D.; Jones, Paul; Carter, Nathan; Hayes, David L.; Saxon, Leslie A.

doi:10.1111/jce.13038

Cited by 6 publications

(5 citation statements)

References 28 publications

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“…[26][27][28][29][30] That is why in our center, since the very first case, we have been programming devices individually, based on the patients' individual characteristics, in order to achieve the best results. 1,7,31 In our study, 3 patients (15%) suffered from a total of 23 IAs. Specifically, the rate of IAs due to non-optimal programming of the device was 5%; due to T-wave oversensing 10%; due to pace/sense lead dislocations 5%; and due to HV LF in 10% of the incidents.…”

Section: Appropriate and Inappropriate Device Therapymentioning

confidence: 48%

“…Implantable cardioverter-defibrillator shocks delivered for reasons other than life-threatening ventricular arrhythmias, known as IA, occur frequently in ICD-equipped patients. 1,[24][25][26] Pediatric patients and patients with CHD have a particularly high rate of IAs, with the largest studies reporting up to 20% of patients receiving them, mainly due to higher heart rates in younger patients, a higher risk of lead malfunction due to more active lifestyles and longer follow-up periods. [26][27][28][29][30] That is why in our center, since the very first case, we have been programming devices individually, based on the patients' individual characteristics, in order to achieve the best results.…”

Section: Appropriate and Inappropriate Device Therapymentioning

confidence: 99%

“…The implementation of ICD therapy has significantly decreased the number of sudden cardiac deaths (SCD) in the adult population. [1][2][3] According to the American Heart Association (AHA) and American College of Cardiology (ACC) recommendations, the secondary prevention indications for ICD therapy are the same in children as in adults. The main indications for ICD implantation in the pediatric population are primary electrical heart disease (PED), cardiomyopathy (CMP), congenital heart defect (CHD) post-surgical correction, ventricular tachycardia (VT), and idiopathic ventricular fibrillation (VF) in patients with an anatomically normal heart.…”

Section: Introductionmentioning

confidence: 99%

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Long-term follow-up of implantable cardioverter-defibrillators in children: Indications and outcomes

et al. 2019

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Background. Validation data of the use of implantable cardioverter-defibrillators (ICD) in the pediatric population is insufficient, with limited follow-up periods. Objectives. The aim of the study was to report on 17 years of experience with implantable cardioverterdefibrillator (ICD) therapy in children and young adults. Material and methods. This retrospective review included patients below the age of 18 years at the time of ICD implantation between May 2000 and December 2017. For the statistical analysis, the sample was divided into groups by gender and the type of indications for ICD implantation (primary vs secondary prevention). Results. The study group included 20 children (8 female, 12 male) who underwent ICD implantation for primary or secondary prevention of sudden cardiac death (SCD). The average age at the time of the initial procedure was 15.6 years (range: 3.8-17.7 years). Primary electrical disease (PED) was present in 9 patients, cardiomyopathy (CMP) in 9 and 2 others had congenital heart defects (CHDs). The median follow-up time was 6.7 years (range: 0.4-12.5 years). The outcomes of ICD therapy were analyzed. No differences between the sexes were found in terms of treatment strategy effectiveness (p > 0.05). The girls were more often treated as primary prevention (p = 0.009). After implantation, all the patients were on optimal pharmacotherapy. Alltogether there were 126 ICD interventions in 11 patients, including 23 inadequate interventions (IA) in 2 children (18.2%).Three children (15%) died due to electrical storms. In the per-procedure analysis, the overall freedom rate from ICD lead replacement was 90%, 80% and 57% at 1, 5 and 10 years of observation, respectively. Conclusions. Implantable cardioverter-defibrillator implantation indications in children are more heterogeneous in comparison to adult population. In the pediatric population undergoing ICD implantation, the treatment strategy is influenced by gender. The rate of inappropriate ICD discharges (IA) in our group of pediatric patients was low. Rigorous pharmacotherapy and individual ICD programming seemed of paramount importance. Lead malfunctions LF constituted the most prevalent complication observed.

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Section: Appropriate and Inappropriate Device Therapymentioning

confidence: 48%

Section: Appropriate and Inappropriate Device Therapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term follow-up of implantable cardioverter-defibrillators in children: Indications and outcomes

et al. 2019

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“…Inappropriate shock for AF or atrial flutter can be associated with an increased overall risk of mortality, particularly in younger patients ( Figure 3 ). [ 32 ]…”

Section: Challenging Arrhythmiasmentioning

confidence: 99%

Successful Identification of and Discrimination Between Atrial and Ventricular Arrhythmia with the Aid of Pacing and Defibrillator Devices

Mukherjee

Sohal

Shanmugam

et al. 2021

Arrhythm Electrophysiol Rev

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The presence of supraventricular tachycardia is the leading cause of inappropriate shock in ICD recipients, and it can be a significant cause of morbidity, psychological distress and worsened clinical outcome. Modern pacing and ICD systems offer a number of discriminators that are integrated into algorithms to differentiate sustained ventricular tachycardia from supraventricular tachycardia. These algorithms can be adapted and optimised for each individual patient to ensure that only those arrhythmias that need treatment through the use of an ICD, are actually treated. This review summarises the single- and dual-chamber discriminators that can be used in the detection and classification of tachyarrhythmias.

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“…Implantable cardioverter defibrillator (ICD) can effectively terminate malignant ventricular tachycardia (VT)/ventricular fibrillation (VF) and prevent sudden death [ 1 – 3 ]. Electrical storm (ES), characterized by multiple attacks of VT or ventricular fibrillation (VF), is an unstable condition for which management and prevention are still a challenge.…”

Section: Introductionmentioning

confidence: 99%

An inappropriate pacing threshold increase after repeated electrical storm in a patient with implantable cardioverter defibrillator

Zhu¹,

Gu²,

Xu³

2017

BMC Cardiovasc Disord

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BackgroundImplantable cardioverter defibrillators (ICD) are capable of effectively terminating malignant ventricular arrhythmia and are the most effective way to prevent sudden cardiac death. However, some evidences demonstrated that both anti-tachycardia pacing (ATP) and ICD shock can also bring adverse prognosis.Case presentationA 66-year-old Han Chinese man with prior ICD implantation was admitted to our hospital because of frequent ICD shocks. Although intravenous amiodarone and esmolol succinate were administered daily, the patient suffered 155 episodes of VT/VF during 8 weeks after implantation. After repeated discharge of the device, the pacing threshold of the patient increased gradually. Considering the inappropriate increase of the pacing threshold, we decided to reposition the right ventricular (RV) lead with good sensing and threshold parameters confirmed. Subsequent 22 months interrogation follow-up revealed a stable lead position and electrical specifications. Furthermore, antiarrhythmic drugs were maximally increased, while ATP burst was remarkably decreased and the inappropriate ICD shock never occurred until now.ConclusionAn inappropriate pacing threshold was increased secondary to repeated ICD electrical storm. A timely active lead position adjustment reduced the pacing threshold and eliminated the risk of premature battery depletion.Electronic supplementary materialThe online version of this article (10.1186/s12872-017-0695-y) contains supplementary material, which is available to authorized users.

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Implantable Cardioverter Defibrillator Programming Characteristics, Shocked Rhythms, and Survival Among Patients Under Thirty Years of Age

Abstract: Differences in survival, shock incidence, and prognostic significance of VT/VF and AF/AFL exist between younger and older ICD recipients. These suggest distinct differences in myocardial substrates and diseases that ultimately impact ICD management.

Cited by 6 publications

References 28 publications

Long-term follow-up of implantable cardioverter-defibrillators in children: Indications and outcomes

Long-term follow-up of implantable cardioverter-defibrillators in children: Indications and outcomes

Successful Identification of and Discrimination Between Atrial and Ventricular Arrhythmia with the Aid of Pacing and Defibrillator Devices

An inappropriate pacing threshold increase after repeated electrical storm in a patient with implantable cardioverter defibrillator

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