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Implantable cardioverter-defibrillators for children and young adolescents: mortality benefit confirmed—what’s next?
  1. S F Sears1,
  2. J B Conti2
  1. 1Department of Clinical Health Psychology, University of Florida, Gainesville, Florida, USA
  2. 2Division of Cardiovascular Medicine, University of Florida
  1. Correspondence to:
    Samuel F Sears
    PhD, University of Florida, Department of Clinical & Health Psychology, Box 100165 UF Health Science Center, Gainesville, FL 32610, USA; ssearshp.ufl.edu

https://doi.org/10.1136/hrt.2003.021295

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    The implantable cardioverter-defibrillator can present significant psychological difficulties for some younger patients, not least because of increased lifestyle disruption and the likely experience of shock

    The implantable cardioverter-defibrillator (ICD) is the treatment of choice for potentially life threatening ventricular arrhythmias. Consistent with the adult clinical trial data for both primary and secondary prevention, Gradaus and colleagues1 followed children and young adolescents with ICDs for an average of four years and found that the children’s total survival was excellent (95.8%). The demonstrated mortality benefit demonstrated by Gradaus and colleagues1 in this issue of Heart allows us to turn our attention to psychosocial issues and quality of life (QoL) of young ICD patients.2

    We reported that younger age and greater frequency of ICD firings were the two most commonly reported ICD specific risk factors for psychological distress.3 Younger patients (50 years and younger) may experience greater problems because of increased lifestyle disruption and distressing social comparisons.2 In addition to adjusting to the risk of potentially life threatening arrhythmias, young …

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