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:10/13/2017)... ... October 13, 2017 , ... Apple Rehab Shelton Lakes ... a mock evacuation of the facility as part of a disaster drill on October ... Hose EMS and Shelton City Emergency Manager, as well as the Connecticut Long ...
(Date:10/13/2017)... BASKING RIDGE, N.J. (PRWEB) , ... October 13, 2017 , ... ... second annual Holly Day Market. Featuring a collection of specialty vendors and unique items ... myriad of personalized and quality-focused health and wellness services offered by the VNA. ...
(Date:10/13/2017)... Milford, NJ (PRWEB) , ... October 13, 2017 , ... ... weekend at scenic Alexandria Park in Milford, NJ. This free event, sponsored by ... and physical activity. The fun run is geared towards children of all ages; ...
(Date:10/13/2017)... ... ... Talented host, actor Rob Lowe, is introducing a segment ... of "Success Files," which is an award-winning educational program broadcasted on PBS Member ... with passion and integrity. , Sciatica occurs when the sciatic nerve in the ...
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... “The Journey: ... faced every danger possible to save lost souls in the Philippines. “The Journey: From ... Carole is a dedicated teacher of the Bible. She has taught all ages and ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... -- Eli Lilly and Company (NYSE: LLY ) ... of 2017 on Tuesday, October 24, 2017. Lilly will ... the investment community and media to further detail the ... begin at 9 a.m. Eastern time. Investors, media and ... the conference call through a link that will be ...
(Date:9/28/2017)... 2017 Cohen Veterans Bioscience and Early Signal ... wearable and home sensors for real-time monitoring of patients ... a nonprofit organization focused on disruptive health solutions for ... analytical system to record and integrate behavioral, cognitive, physiological ... ...
(Date:9/23/2017)... Pa. , Sept. 22, 2017 Janssen ... a complete response letter from the U.S. Food and ... seeking approval of sirukumab for the treatment of moderately ... letter indicates additional clinical data are needed to further ... moderately to severely active RA. ...
Breaking Medicine Technology: