Document Detail


Endocardial implantation of a cardioverter defibrillator in early childhood.
MedLine Citation:
PMID:  16403075     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Experience in endovascular/endocardial techniques for implanting implantable cardioverter defibrillators in early childhood is limited. Potentially, this type of approach could limit the surgical risk, while increasing ICD therapy efficacy. The safety and feasibility of adopting a complete endovascular/endocardial approach for implanting ICDs is assessed by considering the cases of two young children. METHODS AND RESULTS: Two boys, aged 3 and 6 years, were implanted with ICD for a history of syncope and documented ventricular tachycardia (VT). A complete endovascular/endocardial approach was adopted consisting of positioning a bipolar pacing and sensing lead in the right ventricular (RV) apex with intravascular redundancy forming a loop in the inferior vena cava (IVC), and a caval coil placed in the IVC. Sensing values (7-8 mV), pacing threshold (0.5-0.6 V/0.5 msec), and defibrillation testing (case 1 = 10 J, case 2 = 20 J) were all acceptable. During follow-up, in both cases ICD intervened correctly. In one case, 16 months after implantation, because of change in the IVC coil-active can vector, the IVC coil was effectively repositioned to a more distal position. CONCLUSION: A complete endovascular/endocardial ICD implantation technique in early childhood is both feasible and safe. This approach avoids thoracotomy and ensures ICD therapy efficacy.
Authors:
Maurizio Gasparini; François Regoli; Paola Galimberti; Silvia G Priori
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  16     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-11     Completed Date:  2006-03-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1381-3     Citation Subset:  IM    
Affiliation:
Electrophysiology and Pacing Unit, IRRCS, Istituto Clinico Humanitas, Rozzano, Milano, Italy. maurizio.gasparini@humanitas.it
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Cardiac Pacing, Artificial / adverse effects*
Child
Child, Preschool
Defibrillators, Implantable / adverse effects*
Endocardium / physiopathology*
Humans
Male
Risk Assessment
Syncope*
Tachycardia, Ventricular / therapy*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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