The use of implantable cardioverter-defibrillators in pediatric patients awaiting heart transplantation
Section snippets
Methods
We performed a retrospective review of patient records and clinical databases at 9 pediatric cardiology centers: Stanford University; University of California, San Francisco; The Children’s Hospital, Boston; University of Southern California; University of Utah; Sick Children’s Hospital, Toronto; Children’s Hospital and Regional Medical Center, Seattle; Children’s Hospital Denver; and Texas Children’s Hospital, Houston. Inclusion criteria for entry into the study were as follows:
- 1.
Patients
Patients
A total of 28 patients (16 males) were eligible for inclusion. The median age at implant was 14.3 years (11 months to 21 years) with a median weight of 49 kg (11.7-88 kg) (Table 1). There were 6 patients who were ≤10 years of age, and 22 between the ages of 11 and 21. Twenty-one patients successfully received cardiac transplantation and 2 patients died from refractory congestive heart failure while awaiting a donor.
The most common diagnosis in this patient population was cardiomyopathy (Table 2
Discussion
There has been much interest in the use of ICD therapy for prevention of sudden death in adult patients awaiting transplant.14., 15. Brugada and colleagues found that 71% of their patients with malignant ventricular arrhythmias awaiting transplant had appropriate discharges. No such studies have been performed in the pediatric population, which is, in many important respects, a distinct group with a different heart failure substrate. The indications for the use of ICD therapy in pediatric
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