TY - JOUR
T1 - Preliminary Experience with Nonthoracotomy Implantahle Cardioverter Defihrillators in Young Patients
AU - for THE MEDTRONIC TRANSVENE INVESTIGATORS
AU - KRON, JACK
AU - SILKA, MICHAEL J.
AU - OHM, O. ‐J
AU - BARDY, GUST
AU - BENDITT, DAVID
PY - 1994/1
Y1 - 1994/1
N2 - Implantable cardioverter defihrillators represent an important treatment option for patients with life‐threatening tachyarrhythinias. However, the requirement for surgical access to the thorax contributes to significant procedural morbidity with ICD implantation. This study was performed to assess an initial experience with a nonthoracotomy approach to ICD lead implantation in young patients. An international survey identified 17 patients, ranging in age from 12–20 years (mean = 16.7 ± 2.4) and weighing from 33–89 kg (mean = 60.6 ± 13.3), who had undergone placement of the Medtronic TransveneR defibrillator lead system. Implant indications were aborted sudden cardiac death in 15 patients and recurrent ventricular tachycardia or familial sudden death in 2 patients. At a median follow‐up of 7.9 months, 9 of 17 patients had received at least one ICD therapy. There have been no deaths. Complications included patch or generator erosion (3 patients), lead dislodgement (1 patient), and ICD system infection requiring explanation (1 patient). The initial experience with nonthoracotomy ICDs in young patients appears promising. This approach may be particularly advantageous for patients who have undergone prior thoracotomy. Prospective clinical trials will be required to establish the applicability of these lead systems to select patient populations.
AB - Implantable cardioverter defihrillators represent an important treatment option for patients with life‐threatening tachyarrhythinias. However, the requirement for surgical access to the thorax contributes to significant procedural morbidity with ICD implantation. This study was performed to assess an initial experience with a nonthoracotomy approach to ICD lead implantation in young patients. An international survey identified 17 patients, ranging in age from 12–20 years (mean = 16.7 ± 2.4) and weighing from 33–89 kg (mean = 60.6 ± 13.3), who had undergone placement of the Medtronic TransveneR defibrillator lead system. Implant indications were aborted sudden cardiac death in 15 patients and recurrent ventricular tachycardia or familial sudden death in 2 patients. At a median follow‐up of 7.9 months, 9 of 17 patients had received at least one ICD therapy. There have been no deaths. Complications included patch or generator erosion (3 patients), lead dislodgement (1 patient), and ICD system infection requiring explanation (1 patient). The initial experience with nonthoracotomy ICDs in young patients appears promising. This approach may be particularly advantageous for patients who have undergone prior thoracotomy. Prospective clinical trials will be required to establish the applicability of these lead systems to select patient populations.
KW - implantable cardioverter defibrillator
KW - pediatric cardiology
KW - sudden death
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U2 - 10.1111/j.1540-8159.1994.tb01347.x
DO - 10.1111/j.1540-8159.1994.tb01347.x
M3 - Article
C2 - 8139991
AN - SCOPUS:0028047843
SN - 0147-8389
VL - 17
SP - 26
EP - 30
JO - PACE - Pacing and Clinical Electrophysiology
JF - PACE - Pacing and Clinical Electrophysiology
IS - 1
ER -