Abstract
Background: In children, we need to decide the indications for implantable cardioverter defibrillator (ICD) implantation in consideration of somatic growth potential, complications, and long-term maintenance. In Japan, few studies on ICD therapy have been reported.
Objective: This study was performed to examine the indications for ICD and situations after ICD implantation.
Method: Six patients with first ICD implantation at <18 years old were examined. Demographic information, indications, approach, appropriate and inappropriate discharge data, additional therapy (catheter ablation and medication) and complications were recorded for all patients.
Results: The underlying pathology was idiopathic ventricular fibrillation (Vf) in two patients, and ventricular tachycardia after repaired tetralogy of Fallot, ventricular tachycardia after fulminant myocarditis, dilated cardiomyopathy, and long QT syndrome in one patient each. According to the guidelines of the Japanese Circulation Society, the criteria for ICD implantation were judged as class I in five patients and unclassified in one patient. The median age at ICD implantation was 12.9 years (range, 3.8-17.9 years). Duration of follow-up was 3.0 years (range, 0.8-4.9 years). Three patients received four appropriate discharges. One patient received four inappropriate discharges. Catheter ablation was performed in two cases, and medication for preventing arrhythmia was administered in five cases. No major complications were encountered during follow-up.
Conclusion: Indications for ICD therapy appear appropriate because most patients with class I experienced significant rates of appropriate discharge. No major complications were seen during follow-up. Even in the pediatric population, ICD implantation for class I patients is beneficial for preventing sudden cardiac death.
