Skip to main content
SpringerLink
Log in

Implantable cardioverter defibrillator implantation in children in The Netherlands

  • Original Paper
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

To evaluate the indications, underlying cardiac disorders, efficacy and complications involved with implantable cardioverter-defibrillators (ICDs) in paediatric patients in The Netherlands, the records of all patients aged 18 years or younger who underwent ICD placement were reviewed retrospectively. Between January 1995 and September 2002, 23 patients (11 males, 12 females; median age 12 years, range 6 months to 16 years) underwent ICD implantation. The ICD was implanted for aborted sudden cardiac death ( n =14), syncope ( n =5) or for primary prevention of sudden cardiac death ( n =4). Underlying cardiac disorders were electrical diseases ( n =16), hypertrophic or dilated cardiomyopathy ( n =4) and congenital cardiac malformations ( n =3). Five patients had an epicardially placed ICD, while 18 underwent a transvenous approach. The generator was placed in an abdominal position in eight patients, whereas it was placed in the subpectoral region in 15. There was no early mortality. Median hospital stay was 5 days (range 2–30 days). Median follow-up time was 29 months (range 1 month to 7 years). Seven patients experienced an inappropriate shock after a median period of 7 months; five patients an appropriate shock after a median period of 3 months. The reasons for inappropriate shock were supraventricular tachycardia ( n =1), sinus tachycardia ( n =4) or T-wave sensing ( n =2). One patient with malignant long QT syndrome died of intractable arrhythmias and irreversible cardiomyopathy. Generator replacement was necessary in four patients after 28, 44, 51 and 54 months respectively. Conclusion:Implantable cardioverter-defibrillator implantation in paediatric patients is a safe procedure with a good medium-term outcome. The most serious problem is the occurrence of a significant number of inappropriate shocks.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

ICD :

implantable cardioverter defibrillator

LQTS :

long QT syndrome

LV :

left ventricle

SCD :

sudden cardiac death

References

  1. Chatrath R, Porter CJ, Ackerman MJ (2002) Role of transvenous implantable cardioverter-defibrillators in preventing sudden cardiac death in children, adolescents, and young adults. Mayo Clin Proc 77: 226–231

    Google Scholar 

  2. Elliott PM, Sharma S, Varnava A, Poloniecki J, Rowland E, McKenna WJ (1999) Survival after cardiac arrest or sustained ventricular tachycardia in patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 33: 1596–1601

    Google Scholar 

  3. Gradaus R, Hammel D, Kotthoff S, Bocker D (2001) Nonthoracotomy implantable cardioverter defibrillator placement in children. Use of subcutaneous array leads and abdominal placed implantable cardioverter defibrillators in children. J Cardiovasc Electrophysiol 12: 356–360

    Google Scholar 

  4. Grimm W, Hoffmann J, Muller HH, Maisch B (2002) Implantable defibrillator event rates in patients with idiopathic dilated cardiomyopathy, nonsustained ventricular tachycardia on Holter and a left ventricular ejection fraction below 30%. J Am Coll Cardiol 39: 780–787

    Google Scholar 

  5. Groh WJ, Silka MJ, Oliver RP, Halperin BD, McAnulty JH, Kron J (1996) Use of implantable cardioverter-defibrillators in the congenital long QT syndrome. Am J Cardiol 78: 703–706

    Google Scholar 

  6. Hamilton RM, Dorian P, Gow RM, Williams WG (1996) Five-year experience with implantable defibrillators in children. Am J Cardiol 77: 524–526

    Google Scholar 

  7. Hauer RNW, Aliot E, Block M, Capucci A, Luderitz B, Santini M, Vardas PE on behalf of the study group on guidelines on ICDs of the working group on arrhythmias and the working group on cardiac pacing of the European Society of Cardiology (2001). Indications for implantable cardioverter defibrillator (ICD) therapy. Eur Heart J 22: 1074–1081

    Google Scholar 

  8. Hazekamp MG, Blom NA, Schoof PH, Schalij MJ, Dion RAE (2001) Implantation of cardioverter device in young children: the perirenal approach. Ann Thorac Surg 71: 1382–1383

    Google Scholar 

  9. Kral MA, Spotnitz HM, Hordof A, Bigger Jr JT, Steinberg JS, Livelli FD (1989) Automatic implantable cardioverter defibrillator implantation for malignant ventricular arrhythmias associated with congenital heart disease. Am J Cardiol 63: 118–119

    Google Scholar 

  10. Kron J, Oliver RP, Norsted S, Silka MJ (1990) The automatic implantable cardioverter-defibrillator in young patients. J Am Coll Cardiol 16: 896–902

    Google Scholar 

  11. Liberthson RR (1996) Sudden death from cardiac causes in children and young adults. N Engl J Med 340: 1039–1044

    Google Scholar 

  12. Link MS, Hill SL, Cliff DL, Swygman CA, Foote CB, Homoud MK, Wang PJ, Estes III NAM, Berul CI (1999) Comparison of frequency of complications of implantable cardioverter-defibrillators in children versus adults. Am J Cardiol 83: 263–266

    Google Scholar 

  13. Love BA, Barrett KS, Alexander ME, Bevilacqua LM, Epstein MR, Triedman JK, Walsh EP, Berul CI (2001) Supraventricular arrhythmias in children and young adults with implantable cardioverter defibrillators. J Cardiovasc Electrophysiol 12: 1097–1101

    Google Scholar 

  14. Molina JE, Benditt DG, Adler S (1995) Crinkling of epicardial defibrillator patches; a common and serious problem. J Thorac Cardiovasc Surg 110: 258–264

    Google Scholar 

  15. Moss AJ, Schwartz PJ, Crampton RS, Tzivoni D, Locati EH, MacCluer J, Hall WJ, Weitkamp L, Vincent GM, Garson Jr A (1991) The long QT syndrome. Prospective longitudinal study of 328 families. Circulation 84: 1136–1144

    Google Scholar 

  16. Moss AJ, Zareba W, Hall WJ, Schwartz PJ, Crampton RS, Benhorin J, Vincent GM, Locati EH, Priori SG, Napolitano C, Medina A, Zhang L, Robinson JL, Timothy K, Towbin JA, Andrews ML (2000) Effectiveness and limitations of beta-blocker therapy in congenital long-QT syndrome. Circulation 101: 616–623

    Google Scholar 

  17. Moss AJ, Daubert J, Zareba W (2002) Madit-II: clinical implications. CEPR 6: 463–465

    Google Scholar 

  18. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, Daubert JP, Higgins SL, Brown MW, Andrews ML (2002) Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 346: 877–883

    Google Scholar 

  19. Oechslin EN, Harrison DA, Connelly MS, Webb GD, Siu SC (2000) Mode of death in adults with congenital heart disease. Am J Cardiol 86: 1111–1116

    Google Scholar 

  20. Park JK, Pollock ME (1999) Use of an implantable cardioverter-defibrillator in an eight-month-old infant with ventricular fibrillation arising from a myocardial fibroma. PACE 22: 138–139

    Google Scholar 

  21. Roden DM, Lazzara R, Rosen M, Schwartz PJ, Towbin J, Vincent GM for the SADS foundation task force on LQTS (1996) Multiple mechanisms in the long-QT syndrome. Current knowledge, gaps, and future directions. Circulation 94: 1996–2012

    Google Scholar 

  22. Sears SE Jr, Conti JB (2003) Understanding implantable cardioverter defibrillator shocks and storms: medical and psychosocial considerations for research and clinical care. Clin Cardiol 26: 107–111

    Google Scholar 

  23. Silka MJ, Kron J, Dunnigan A, Dick II M (1993) Sudden cardiac death and the use of implantable cardioverter-defibrillators in pediatric patients. Circulation 87: 800–807

    Google Scholar 

  24. Silka MJ, Hardy BG, Menashe VD, Morris CD (1998) A population-based prospective evaluation of risk of sudden cardiac death after operation for common congenital heart defects. J Am Coll Cardiol 32: 245–251

    Google Scholar 

  25. Stefanelli CB, Bradley DJ, Leroy S, Dick II M, Serwer GA, Fischbach PS (2002) Implantable cardioverter deflbrillator therapy for life-threatening arrhythmias in young patients. J Interv Cardiac Electrophysiol 6: 235–244

    Google Scholar 

  26. Steinberger J, Lucas RV, Edwards JE, Titus JL (1996) Causes of sudden unexpected cardiac death in the first two decades of life. Am J Cardiol 77: 992–995

    Google Scholar 

  27. Stephenson EA, Collins KK, Dubin AM, Epstein MR, Hamilton RM, Kertesz NJ, Alexander ME, Cecchin F, Triedman JK, Walsh EP, Berul CI (2002) Circadian and seasonal variation of malignant arrhythmias in a pediatric and congenital heart disease population. J Cardiovasc Electrophysiol 13: 1009–1014

    Google Scholar 

  28. Thogersen AM, Helvind M, Jensen T, Andersen H, Jacobsen JR, Chen X (2001) lmplantable cardioverter defibrillator in a 4-month-old infant with a vascular heart tumor. PACE 24: 1699–1700

    Google Scholar 

  29. Walsh EP (2002) Arrhythinias in patients with congenital heart disease. Card Electrophysiol Rev 6: 422–430

    Google Scholar 

  30. Watanabe H, Hayashi J, Haga M, Saito M, Suzuki H, Sato S (2001) Succesful implantation of a cardioverter defibrillator in an infant. Ann Thorac Surg 72: 125–127

    Google Scholar 

  31. Wilson WR, Greer GE, Grubb BP (1998) Implantable cardioverter-defibrillators in children: a single-institutional experience. Ann Thorac Surg 65: 775–778

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Paediatric Cardiology, Erasmus MC-Sophia, Dr. Molewaterplein 60, 3015 GJ , Rotterdam, The Netherlands

    A. Derk Jan Ten Harkel

  2. Department of Paediatric Cardiology, Leiden University Medical Centre, Leiden, The Netherlands

    Nico A. Blom

  3. Department of Paediatric Cardiology, University Hospital Nijmegen, Nijmegen, The Netherlands

    Annette G. Reimer

  4. Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands

    Raymond Tukkie

  5. Department of Paediatric Cardiology, Wilhelmina Children’s Hospital, Utrecht, The Netherlands

    Narayanswami Sreeram

  6. Department of Paediatric Cardiology, Academic Hospital Groningen, Groningen, The Netherlands

    Margreet T. E. Bink-Boelkens

Authors
  1. A. Derk Jan Ten Harkel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nico A. Blom
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Annette G. Reimer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Raymond Tukkie
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Narayanswami Sreeram
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Margreet T. E. Bink-Boelkens
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Derk Jan Ten Harkel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ten Harkel, A.D.J., Blom, N.A., Reimer, A.G. et al. Implantable cardioverter defibrillator implantation in children in The Netherlands. Eur J Pediatr 164, 436–441 (2005). https://doi.org/10.1007/s00431-005-1668-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-005-1668-1

Keywords

Search

Navigation