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Scientific letters
Potential benefit from implantable cardioverter-defibrillator therapy in children and young adolescents
  1. R Gradaus1,
  2. C Wollmann1,
  3. J Köbe1,
  4. D Hammel2,
  5. S Kotthoff3,
  6. M Block4,
  7. G Breithardt1,
  8. D Böcker1
  1. 1Departments of Cardiology & Angiology, University Hospital Münster, Münster, Germany
  2. 2Department of Cardiothoracic Surgery, University Hospital Münster
  3. 3Department of Paediatric Cardiology, University Hospital Münster
  4. 4Hospital Augustinum, Munich, Germany
  1. Correspondence to:
    Dr R Gradaus
    Medizinische Klinik und Poliklinik C, (Kardiologie und Angiologie), Universitätsklinikum Münster, D-48129, Münster, Germany; gradausuni-muenster.de

https://doi.org/10.1136/hrt.2003.014266

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    Ever since Mirowski implanted a defibrillator into a patient, the implantable cardioverter-defibrillator (ICD) has evolved to be the treatment of choice in patients with life threatening ventricular arrhythmias.1 Unlike in adults, the indication and benefit from ICD treatment is not well established in children. Children mainly differ from adult patients treated with an ICD by the underlying heart disease, the degree of heart failure and left ventricular function. The most common types of associated underlying cardiac diseases associated with sudden death in children are cardiomyopathies (often without a severe haemodynamic deterioration of the left ventricle), primary electrical diseases and corrected congenital heart defects, which are associated with a 25–100 fold increased risk for sudden cardiac death.2 Thus, this study was performed to analyse the potential benefit of ICDs in children and young adolescents who have a history of life threatening ventricular arrhythmias or are at high risk of an arrhythmic sudden cardiac death.

    METHODS

    Between 1989 and 2001, all patients aged 18 years or younger who were treated with an ICD with extended memory function (storage of electrogram and/or RR intervals from treated episodes) were included in the study. All the children had a history of sustained ventricular tachyarrhythmia, aborted sudden cardiac death, syncope attributed to ventricular tachyarrhythmias, or were at high risk of sudden cardiac death.

    The following end points were used: (1) total death; …

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