Document Detail


Epicardial implantable cardioverter-defibrillator system placed in a 4.9-kg infant.
MedLine Citation:
PMID:  21841874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Implantable cardioverter-defibrillators have aided the prevention of sudden cardiac death in adults. The hope is to provide similar benefits to the pediatric population as the devices become smaller. Herein, we present the case of a 4.9-kg, 5-week-old infant boy who presented with cardiopulmonary arrest. After emergency defibrillation, conventional treatment options included long-term hospitalization for later cardioverter-defibrillator implantation, or installation of an external defibrillator with subsequent home telemetry. On the basis of the infant's body dimensions, we decided that an epicardial implantable cardioverter-defibrillator was feasible and the best option. We performed a median sternotomy and placed a Vitality® implantable cardioverter-defibrillator with a 25-cm defibrillator coil and a 35-cm bipolar ventricular lead. The patient experienced no postoperative morbidity or rhythm disturbances and was discharged from the hospital on postoperative day 5. He was placed on β-blocker therapy and has remained well for 3 years.Although external devices can be placed in a small patient, we believe that they are too susceptible to lead damage and lead migration, and that the defibrillator thresholds are less reliable. We think that dysrhythmias even in very small children can be treated effectively and safely with use of an epicardial implantable cardioverter-defibrillator. To our knowledge, this 4.9-kg infant is the smallest patient to have undergone a successful implantation of this kind.
Authors:
Roosevelt Bryant; Amir Aboutalebi; Jeffrey J Kim; Naomi Kertesz; David L S Morales
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  38     ISSN:  1526-6702     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2011  
Date Detail:
Created Date:  2011-08-15     Completed Date:  2012-01-05     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  421-3     Citation Subset:  IM    
Affiliation:
Department of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Arrhythmias, Cardiac / complications,  diagnosis,  physiopathology,  therapy*
Body Weight*
Death, Sudden, Cardiac / etiology,  prevention & control*
Defibrillators, Implantable*
Electric Countershock / instrumentation*
Equipment Design
Heart Arrest / diagnosis,  etiology,  physiopathology,  therapy*
Humans
Infant
Male
Pericardium
Sternotomy
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists
Comments/Corrections

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


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