The automatic implantable cardioverter-defibrillator in young patients

Department of Medicine, Oregon Health Sciences University, Portland 97201-3098.

An international survey identified 40 patients less than 20 years old who underwent surgical implantation of an automatic implantable cardioverter-defibrillator (AICD). There was a history of aborted sudden cardiac death or sustained ventricular tachycardia in 92.5% of these patients. Twenty-two patients (55%) had structural heart disease; dilated and hypertrophic cardiomyopathy were the most common diagnoses. Eighteen patients (45%) had primary electrical abnormalities including seven with the congenital long QT syndrome. There were no perioperative deaths associated with device implantation. Concomitant drug therapy was administered to 75% of the patients. Defibrillator discharge occurred in 70% of the patients, with 17 patients (42.5%) receiving at least one appropriate shock. There were two sudden and two nonsudden deaths at 28.2 months' median follow-up. Sudden death-free survival rates by life table analysis at 12 and 33 months were 0.94 and 0.88, respectively. Total survival rates at 12 and 33 months were 0.94 and 0.82, respectively. The AICD represents an effective treatment approach for young patients with life-threatening ventricular tachyarrhythmias.

This article has been cited by other articles:

				A. Pedrote, F. J. Morales, L. Garcia-Riesco, and F. Errazquin Documented exercise-induced cardiac arrest in a paediatric patient with hypertrophic cardiomyopathy Europace, June 1, 2006; 8(6): 430 - 433. [Abstract] [Full Text] [PDF]

				A. D.J. Ten Harkel, M. Witsenburg, P. L. de Jong, L. Jordaens, M. Wijman, and A. A.M. Wilde Efficacy of an implantable cardioverter-defibrillator in a neonate with LQT3 associated arrhythmias Europace, January 1, 2005; 7(1): 77 - 84. [Abstract] [Full Text] [PDF]

				P. M. Elliott, J. Poloniecki, S. Dickie, S. Sharma, L. Monserrat, A. Varnava, N. G. Mahon, and W. J. McKenna Sudden death in hypertrophic cardiomyopathy: identification of high risk patients J. Am. Coll. Cardiol., December 1, 2000; 36(7): 2212 - 2218. [Abstract] [Full Text] [PDF]

				C.-E. Chiang and D. M. Roden The long QT syndromes: genetic basis and clinical implications J. Am. Coll. Cardiol., July 1, 2000; 36(1): 1 - 12. [Abstract] [Full Text] [PDF]

				P. M. Elliott, S. Sharma, A. Varnava, J. Poloniecki, E. Rowland, and W. J. McKenna Survival after cardiac arrest or sustained ventricular tachycardia in patients with hypertrophic cardiomyopathy J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1596 - 1601. [Abstract] [Full Text] [PDF]