[II-JCKAP1-1] Efficacy of SubcutAneous implantable cardioVErter-defibrillators in < 18 year-old CHILDREN: SAVE-CHILDREN Registry
Keywords:Subcutaneous implantable cardioverter defibrillator, Sudden cardiac death, inappropriate shock
Background:In adult patients, subcutaneous implantable cardioverter defibrillators (S-ICDs) are shown to be as effective as transvenous ICDs regarding the rate of device-related complications and inappropriate shocks. Only a few studies have explored the effectiveness of S-ICDs among children. This research aimed to examine the usefulness and safety of S-ICDs in patients <18 years old.Methods:This study was a multicenter, observational, retrospective study on S-ICD implantations. Patients <18 years old who underwent S-ICD implantations were enrolled. The detailed data on the device implantations and eligibility tests, incidence of appropriate- and inappropriate shocks, and follow-up data were assessed.Results:A total of 62 patients were enrolled from 30 centers. The patients ranged in age from 3 to 18 (median 14 years old [IQR 11.0-16.0 years]). During a median follow up of 27 months (13.3-35.8), a total of 16 patients (26.2 %) received appropriate shocks and 13 (21.3%) received inappropriate shocks. The common causes of the inappropriate shocks were sinus tachycardia (n=4, 30.8%) and T-wave oversensing (n=4, 30.8%). In spite of the physical growth, the number of suitable sensing vectors did not change during the follow up. No one had any lead fractures or device infections in the chronic phase.Conclusions:Our study suggested that S-ICDs can prevent sudden cardiac death in the pediatric population with a low incidence of lead complications or device infections. The number of suitable sensing vectors did not change during the patients' growth.