Premium
Midterm Results of Implantable Cardioverter Defibrillators in Children and Young Adults from a Single Center in Turkey
Author(s) -
AYKAN HAYRETTIN HAKAN,
KARAGOZ TEVFIK,
GULGUN MUSTAFA,
ERTUGRUL ILKER,
AYPAR EBRU,
OZER SEMA,
ALEHAN DURSUN,
CELIKER ALPAY,
OZKUTLU SUHEYLA
Publication year - 2016
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12954
Subject(s) - medicine , implantable cardioverter defibrillator , sudden cardiac death , single center , primary prevention , incidence (geometry) , retrospective cohort study , cardiomyopathy , ventricular fibrillation , population , pediatrics , shock (circulatory) , secondary prevention , disease , heart failure , physics , environmental health , optics
Background Despite concerns about complications with the implantable cardioverter defibrillator (ICD), it is effective for the prevention of sudden cardiac death (SCD). We aimed to analyze our midterm experience with ICD in children and young adults. Methods This retrospective study included patients who were implanted with an ICD between 2001 and 2014. Demographic characteristics, clinical information, shock features, and complications for all patients with ICD were analyzed. The study population was divided into two groups: early‐era patients implanted before 2008, and late‐era patients implanted after 2008. Results Sixty‐nine patients (median age: 12 years, median follow‐up: 52 months) were implanted with an ICD. Diagnostic categories were channelopathy (56.6%), cardiomyopathy (36.2%), congenital heart disease (5.8%), and other (1.4%). We performed implantation for primary prevention in 66.6% (39.3% in early‐era patients and 85.4% in late‐era patients). Thirty‐one (44.9%) received 139 appropriate shocks (66% of total shocks) while 14 (20.2%) received 71 inappropriate shocks. However, there was no statistically significant difference in the use of appropriate shocks in the primary (66.7%) versus the secondary (72.2%) prevention groups. The incidence of appropriate and inappropriate shock was 66.7% and 33.3% in the primary prevention group, and 72.2% and 27.8% in the secondary prevention group, respectively. Two patients died, although only one death was the result of a lead problem. Conclusions Although lead integrity problems, inappropriate shocks, and infections are significant issues, ICD therapy appears to be a safe, effective, and necessary option for the prevention of SCD in both children and young adults.