Journal article
Inappropriate ICD Discharges in Single-Chamber Versus Dual-Chamber Devices in the Pediatric and Young Adult Population
Journal of cardiovascular electrophysiology, Vol.20(3), pp.287-290
Manuscript received 12 March 2008; Revised manuscript received 26 July 2008; Accepted for publication 12 August 2008.
03/2009
DOI: 10.1111/j.1540-8167.2008.01322.x
PMID: 19175843
Abstract
Background: Implantable cardioverter defibrillator (ICD) use is increasing in young patients and is frequently complicated by inappropriate device discharges (IDs), leading to discomfort, anxiety and, potentially, proarrhythmia. Dual-chamber (DC) ICDs may decrease IDs by improving rhythm discrimination, but are associated with increased size, expense, and implant complications. We examined whether the frequency of IDs was the same in dual- and single-chamber (SC) ICDs in young patients.
Methods: A multicenter review of patients <or=30 years of age with ICDs was performed. Demographic data and number of appropriate discharges (ADs) and IDs were collected. ADs and IDs were categorized after review of the episode by the primary electrophysiologist.
Results: Of 168 subjects (SC = 52; female = 76), 41 patients received 139 ADs, while 35 patients received 159 IDs. There were no differences related to gender or primary diagnosis, but patients with SC versus DC devices were younger (12.3 +/- 5.0 years vs 14.9 +/- 4.4 years, P < 0.0001) at implant. SC and DC devices were implanted with the same frequency for primary and secondary prevention. There were no significant differences in the incidence of IDs or ADs between the patients with SC or DC devices (AD: 12/52 SC vs 29/116 DC, P = 0.79; ID 7/52 SC vs 28/116 DC, P = 0.13).
Conclusion: In this cohort of young patients, DC ICDs did not provide added protection from IDs. Hence, the added complexity and cost of an atrial lead appear unwarranted if used solely for assistance with rhythm discrimination in young patients.
Details
- Title: Subtitle
- Inappropriate ICD Discharges in Single-Chamber Versus Dual-Chamber Devices in the Pediatric and Young Adult Population
- Creators
- DAVID LAWRENCE - Department of Pediatrics, Sibley Heart Center-Cardiology, Emory University, Atlanta, GeorgiaNICHOLAS VON BERGEN - Department of Pediatrics, University of Iowa, Iowa City, IowaIAN H LAW - Department of Pediatrics, University of Iowa, Iowa City, IowaDAVID J BRADLEY - Department of Pediatrics, University of Utah, Salt Lake City, UtahMacdonald Dick II - Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USAPATRICIO A FRIAS - Department of Pediatrics, Sibley Heart Center-Cardiology, Emory University, Atlanta, GeorgiaMARGARET J STREIPER - Department of Pediatrics, Sibley Heart Center-Cardiology, Emory University, Atlanta, GeorgiaPETER S FISCHBACH - Department of Pediatrics, Sibley Heart Center-Cardiology, Emory University, Atlanta, Georgia
- Resource Type
- Journal article
- Publication Details
- Journal of cardiovascular electrophysiology, Vol.20(3), pp.287-290
- Edition
- Manuscript received 12 March 2008; Revised manuscript received 26 July 2008; Accepted for publication 12 August 2008.
- DOI
- 10.1111/j.1540-8167.2008.01322.x
- PMID
- 19175843
- NLM abbreviation
- J Cardiovasc Electrophysiol
- ISSN
- 1045-3873
- eISSN
- 1540-8167
- Publisher
- Blackwell Publishing Inc
- Number of pages
- 4
- Language
- English
- Date published
- 03/2009
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics
- Record Identifier
- 9984093367902771
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