Navigation Links
Largest study to date finds benefits of ICDs in children
Date:5/1/2008

More and more children with congenital heart disease are receiving implantable cardioverter-defibrillators (ICDs) to maintain proper heart rhythm. ICDs were first introduced for adults in the 1980s, but little is known about how well they work in children, who account for less than 1 percent of recipients. A report in the April 29 Journal of the American College of Cardiology summarizes the largest pediatric experience to date. It finds the devices to be life-saving, but also suggests that they tend to deliver more inappropriate shocks to children than to adults, making it important to watch children with ICDs closely.

The researchers, led by Charles Berul, MD, a cardiac electrophysiologist at Childrens Hospital Boston, analyzed data from 443 patients who received implants between 1992 and 2004 at one of four pediatric centers. The study included both pediatric heart patients and adults with congenital heart disease. The median age was 16 years (range, 0 to 54).

Among the 409 patients for whom shock data was available, 26 percent had received appropriate shocks from their ICD, averaging four per patient. However, 21 percent had received inappropriate shocks an average of six per patient. When broken down by age, 24 percent of children under 18 had received inappropriate shocks, versus 14 percent of adult patients. While such shocks arent life-threatening, they are very unpleasant like being kicked in the chest, says Berul.

One reason for the inappropriate shocks was that children often have spikes in heart rate that arent normally seen in adults. Children are more active and get their heart rates up faster, Berul says. The devices sometimes have trouble differentiating normal increases in heart rate from abnormal rhythms.

In addition, 14 percent of inappropriate shocks were due to failure of the ICD wires (leads). This was a particular problem in children, who live much longer with their ICDs than adults do, and whose leads can stretch due to activity and growth. Lead failure also requires periodic surgery to replace the wires.

Beruls team is working with device manufacturers to change ICD programming to minimize unnecessary shocks in children and to provide more durable, longer-lasting leads. Children are not an important market for device makers, but they are an important subgroup, Berul says.

Overall, the study shows a benefit of ICDs, but suggests that physicians should give more attention to determining which children with congenital heart disease really need the devices, since not all are at risk for life-threatening arrhythmias. For example, patients who had experienced a prior cardiac event had a higher likelihood of appropriate shocks than those receiving the devices preventively (32 vs. 18 percent), improving the overall cost-benefit ratio.

Berul notes that the current study is by far the largest to date involving the newer generation of ICDs. It confirms the findings of earlier studies, which have looked at older-generation pacemakers and devices implanted only after children were resuscitated from cardiac arrest.


'/>"/>

Contact: Keri Stedman
keri.stedman@childrens.harvard.edu
617-919-3110
Children's Hospital Boston
Source:Eurekalert

Related medicine news :

1. ACP hosts largest medical education meeting for general and subspecialty internists
2. Ohio Health Care Association Hosts Midwests Largest Long-Term Care Convention in Columbus
3. Seniors, minorities to have largest impact on tomorrows America
4. Aurora St. Lukes Medical Center Installs the Countrys Second-Largest Hyperbaric Chamber
5. Medical Tourism Association Announces Worlds Largest Medical Tourism Convention in San Francisco, CA USA - September 9-12, 2008
6. The Mt. Diablo Region YMCA Invites Families to Put Play in Your Day and Bring Healthy Habits Home During the Nations Largest Health Day for Children and Families
7. Creating Healing Environments: Healthcare Industrys Largest Sustainability Conference to be Held May 20-22 in Pittsburgh
8. YMCA of the USA Celebrates YMCA Healthy Kids(R) Day, the Nations Largest Health Day for Children and Families
9. Virginias largest Cardiac Surgery program adopts SPY as standard of care
10. Latest Advances in Diabetes Research to be Presented in San Francisco, California at Worlds Largest Diabetes Conference, June 6-10, 2008
11. Largest ever analysis of DES data demonstrates safety, efficacy in on-and-off-label use
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/29/2017)... , ... March 29, 2017 , ... In the United ... 300,000 people each year develop other types of metastatic brain tumors(3). Though most meningiomas ... brain(3). As efforts focus on finding more effective treatment options, the San Diego ...
(Date:3/29/2017)... ... 2017 , ... Full Contact K9, an Atlanta-based dog services provider, has recently ... assists dog owners in creating legally-enforceable pet trusts for their canine companions. , ... to protect their new companion. Says Evan Dunbar, CEO of Full Contact K9, “When ...
(Date:3/29/2017)... ... March 30, 2017 , ... CHARM CITY RUN WELCOMES MERCY MEDICAL ... that Mercy Medical Center will serve as the official title sponsor of the Baltimore ... June 25, 2017, thousands of women will walk or run the course around the ...
(Date:3/29/2017)... ... March 30, 2017 , ... Sublime Naturals and its founder, ... or "Wonder Spice", it has been used for thousands of years. , "The West ... Heshelow, author of " Turmeric: How to Use it For Your Wellness. Overcome Inflammation, ...
(Date:3/29/2017)... (PRWEB) , ... March 29, 2017 , ... ... hosting several educational opportunities for attending prescribers at the upcoming World Congress, in ... said, “A4M has always been recognized as the visionary leader in the training ...
Breaking Medicine News(10 mins):
(Date:3/29/2017)... 2017  The Global Health Innovative Technology Fund ... to battle infectious diseases around the globe, today ... could help deliver a range of new innovative ... This latest round of targeted support ... testing a pediatric formulation of a drug considered ...
(Date:3/29/2017)... -- The leader in accelerated orthodontics, OrthoAccel ® Technologies, ... Manal Ibrahim , Kenji Ojima , ... featured microlecture presenters at the AcceleDent ® booth ... Annual Session, April 21-25, 2017. Orthodontists and their staff ... 11:20 a.m. On the opening morning of AAO exhibitions, ...
(Date:3/29/2017)... 2017 Transparency Market Research ... an exhaustive study of the U.S. substance abuse treatment ... are functional in this market at present, making ... companies, such as GlaxoSmithKline Plc., Pfizer Inc., Alkermes ... various marketing strategies to increase their visibility, the ...
Breaking Medicine Technology: