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

Vetta, Giampaolo; Parlavecchio, Antonio; Magnocavallo, Michele; Valente, Debora; Caminiti, Rodolfo; Polselli, Marco; Vetta, Francesco; Cirone, Donatello; Cauti, Filippo Maria; Crea, Pasquale; Rossi, Pietro; Chierchia, Gian Battista; Bianchi, Stefano; Asmundis, Carlo de; Rocca, Domenico Giovanni Della

doi:10.1111/pace.14603

Cited by 5 publications

(2 citation statements)

References 15 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: 81%

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: 81%

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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show abstract

“…Despite those concerns, S-ICDs have been successfully implanted in children over 8 years of age and over 38 kg of body mass [ 7 ], or with the body mass index (BMI) over 20 kg/

[ 6 , 8 ]. The results of a recent meta-analysis may favor S-ICD over TV-ICD in the young population, but a trend towards a higher risk of pocket complications [ 9 ] raises concern and underlines the need for a meticulous surgical technique.…”

Section: General Description Of the S-icd Systemmentioning

confidence: 99%

S-ICD Implantation "Tips and Tricks"

Budrejko¹,

Kempa²,

Przybylski³

2023

Rev. Cardiovasc. Med.

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An implantable cardioverter-defibrillator (ICD) was developed to provide protection against sudden cardiac death. Despite being effective in terminating ventricular arrhythmias, traditional transvenous ICDs appeared over time to have certain limitations related to the need for vascular access and the presence of foreign material inside the circulatory system (namely lead failure and infections). A subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to overcome those limitations and to provide prevention against sudden cardiac death from outside the cardiovascular system. Utilization of that modern method of treatment is constantly increasing worldwide, and new centers incorporate implantation of that system in their portfolio. This review aims to present the most relevant issues related to S-ICD implantation procedure, based on experience of the authors and an extensive literature search.

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Recent Advancements in Cardiac Implantable Devices for Pediatric Patients

Kumthekar,

Howard

2024

Curr Pediatr Rep

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Purpose of Review We highlight recent advances in cardiac implantable electronic devices (CIEDs) that are applicable and can be beneficial for pediatric patients. Recent Findings Progress in pacemakers includes the widespread use of leadless pacemakers, development of tools for left bundle area pacing, and the design of novel miniaturized pacemakers and minimally invasive approaches for epicardial device implantation. For implantable cardioverter defibrillators (ICDs), there has been more utilization of the subcutaneous ICD in smaller patients or those with congenital heart disease, and significant improvements in ICD programming as well. Summary Leadless pacemakers have been safely utilized in children, even those under 30 kg with acute and medium-term success. Left bundle area pacing may provide a reduction in pacing-induced cardiomyopathy in the future. Novel miniature pacemakers and approaches to epicardial lead implantation can reduce complications for our smallest patients. Subcutaneous ICDs have been used effectively in the pediatric cohort with similar results to the adult population. ICD programming has been improved to reduce the risk of inappropriate shocks.

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

Cited by 5 publications

References 15 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?

S-ICD Implantation "Tips and Tricks"

Recent Advancements in Cardiac Implantable Devices for Pediatric Patients

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