| Epicardial Implantable Cardioverter-Defibrillator System Placed in a 4.9-kg Infant. | |
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MedLine Citation:
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PMID: 21841874 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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Roosevelt Bryant; Amir Aboutalebi; Jeffrey J Kim; Naomi Kertesz; David L S Morales |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2011-08-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8214622 Medline TA: Tex Heart Inst J Country: United States |
Other Details:
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Languages: eng Pagination: 421-3 Citation Subset: IM |
Affiliation:
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Departments of Congenital Heart Surgery (Drs. Bryant and Morales, and Mr. Aboutalebi) and Pediatric Cardiology (Drs. Kertesz and Kim), Texas Children's Hospital; and Departments of Surgery (Drs. Bryant and Morales, and Mr. Aboutalebi) and Cardiology (Drs. Kertesz and Kim), Baylor College of Medicine; Houston, Texas 77030. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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