Nonthoracotomy Implantable Cardioverter Defibrillator Placement in Children: Use of Subcutaneous Array Leads and Abdominally Placed Implantable Cardioverter Defibrillators in Children
Nonthoracotomy ICD in Children. Introduction: The need to access the right ventricle might preclude transvenous placement of a defibrillation lead at implantable cardioverter defibrillator (ICD) placement, especially in small children or children with complex congenital heart defects. We investigate...
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Published in | Journal of cardiovascular electrophysiology Vol. 12; no. 3; pp. 356 - 360 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Science Inc
01.03.2001
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Subjects | |
Online Access | Get full text |
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Summary: | Nonthoracotomy ICD in Children. Introduction: The need to access the right ventricle might preclude transvenous placement of a defibrillation lead at implantable cardioverter defibrillator (ICD) placement, especially in small children or children with complex congenital heart defects. We investigated a subcutaneous array lead in addition to an abdominally placed “active can” ICD device in two children to avoid a thoracotomy.
Methods and Results: The first child (age 12 years, 138 cm, 41 kg) had transposition of the great arteries with a subsequent surgical intra‐atrial correction by the Mustard technique. The second child (age 14 years, 161 cm, 54 kg) had a single atrium and a single ventricle, d‐transposition of the aorta, and atresia of the main pulmonary artery with a surgical anastomosis between the aorta and the right pulmonary artery by the Cooley technique. The defibrillation threshold was 18 J and < 20 J at initial implantation and at generator replacement in the first patient and 20 J in the second patient. During follow‐up of 6 years and 1 month, respectively, no ICD‐related complications occurred.
Conclusion: In children in whom endocardial, right ventricular placement of a defibrillation lead is precluded, defibrillation is possible and safe between an abdominally placed “active can” ICD device and a subcutaneous array lead. This approach may avoid a thoracotomy in children with no possibility for transvenous ICD placement. |
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Bibliography: | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 |
ISSN: | 1045-3873 1540-8167 |
DOI: | 10.1046/j.1540-8167.2001.00356.x |