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Ann Thorac Surg 1998;65:775-778
© 1998 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Implantable Cardioverter-Defibrillators in Children: A Single-Institutional Experience

William R. Wilson, MD, Georgia E. Greer, MSN, Blair P. Grubb, MD

Division of Pediatric Cardiac Surgery, Medical College of Ohio, Toledo, Ohio, USA,
Division of Cardiology, Medical College of Ohio, Toledo, Ohio, USA

Accepted for publication September 30, 1997.

Dr Wilson, The Children’s Hospital–University Hospital and Clinics, MA 312, One Hospital Dr, Columbia, MO 65212 (e-mail: william_wilson@surgery.missouri.edu).

Background. Implantable cardioverter-defibrillators have been infrequently used in children as therapy for resuscitated sudden death and syncope due to ventricular arrhythmias unresponsive to antiarrhythmics.

Methods. The medical records of 5 children with implantable cardioverter-defibrillators were retrospectively reviewed. All patients had experienced syncope and 3 (60%) an out-of-hospital cardiac arrest. Underlying pathology included hypertrophic cardiomyopathy in 2, long QT syndrome in 2, and ventricular arrhythmia after remote repair of congenital heart disease in 1. Open thoracotomy with epicardial lead placement and transvenous endocardial approaches were used.

Results. There was no early or late mortality in the 5 pediatric patients undergoing implantable cardioverter-defibrillator placement. Postoperative complications occurred more frequently when open thoracotomy was used for placement. At mean follow-up of 34 months, 4 of the 5 (80%) have received shocks.

Conclusions. Implantable cardioverter-defibrillator is a safe and reliable therapy for children with resuscitated sudden death and syncope due to ventricular tachycardia unresponsive to antiarrhythmics. Transvenous lead placement lowers morbidity and hospital length of stay.




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