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Subcutaneous defibrillator implantation in pediatric patients [Anatol J Cardiol]
Anatol J Cardiol. 2016; 16(8): 630-634 | DOI: 10.5152/AnatolJCardiol.2015.6589  

Subcutaneous defibrillator implantation in pediatric patients

İlker Ertuğrul1, Tevfik Karagöz1, Hakan Aykan1, Işıl Yıldırım4, Sema Özer1, Heves Karagöz2, Mustafa Yılmaz3
1Departments of Pediatric Cardiology, Faculty of Medicine, Hacettepe University, Ankara- Turkey
2Anesthesiology and Reanimation, Faculty of Medicine, Hacettepe University, Ankara- Turkey
3Cardiovascular Surgery, Faculty of Medicine, Hacettepe University, Ankara- Turkey
4Pediatric Cardiology, Koç University Hospital, İstanbul- Turkey

Objective: Although sudden cardiac death is rare in children, an intracardiac defibrillator system is indicated in children with various types of cardiomyopathy, primary electrical diseases, and after surgical repair of congenital heart defects. The use of transvenous defibrillator lead systems is limited in pediatric patients because of a small body size and/or limited vascular access. Subcutaneous array leads combined with an abdominally placed generator can enable implantation.
Method: This is a retrospective study of 13 patients who underwent subcutaneous defibrillator implantation between September 2010 and March 2015. The subcutaneous system was preferred because patients were not amenable to transvenous lead placement.
Results: The median patient age was 4.1 years, and the median patient weight was 12.1 kg. Diagnoses of patients were long-QT syndrome in 6, aborted cardiac arrest with left ventricular non-compaction in 3, hypertrophic cardiomyopathy with sustained ventricular tachycardia in 3, and arrythmogenic right ventricular cardiomyopathy in 1. Revision of the subcutaneous lead was required in 5 patients 2–26 months after the implantation. Appropriate shocks were observed in three patients. Inappropriate shock and lead fractures were observed in one patient during the follow-up period. The failure of therapy was observed in one patient. There were no perioperative complications and no early or late deaths.
Conclusion: Subcutaneous defibrillator systems are safe and effective in pediatric patients when the transvenous method is risky and contraindicated. Because the high growth rate in this population leads to lead failures, a close follow-up of this population is essential. (Anatol J Cardiol 2016; 16: 000-00)

Keywords: subcutaneous defibrillator, pediatric, lead failure


İlker Ertuğrul, Tevfik Karagöz, Hakan Aykan, Işıl Yıldırım, Sema Özer, Heves Karagöz, Mustafa Yılmaz. Subcutaneous defibrillator implantation in pediatric patients. Anatol J Cardiol. 2016; 16(8): 630-634

Corresponding Author: İlker Ertuğrul, Türkiye


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