Pediatric Patients

Background. During the past decade, the implantable cardioverter-defibrillator (ICD) has emerged as the primary therapeutic option for survivors of sudden cardiac death (SCD). Investigation of the clinical efficacy of these devices has primarily assessed outcome in adults with coronary artery disease. The purpose of this cooperative, international study was to evaluate the impact of ICDs on the pediatric population of SCD survivors, based on an analysis of the clinical characteristics and outcomes of young patients who underwent ICD implantation following an episode of life-threatening ventricular tachycardia or resuscitation from SCD. Methods and Results. An initial data base, established by contacting the manufacturers of the various commercially and investigationally available devices, identified 177 patients who were less than 20 years of age at the time of initial implantation of an ICD. With this data base as a reference, detailed responses were subsequently obtained from physicians involved in the care of 125 (71%) of these patients. The patients ranged in age from 1.9 to 19.9 years (mean, 14.5±4 years) and weighed 9.7-117 kg (mean, 44.6±14 kg). Of the 125 patients, 76 % were survivors of SCD, 10 % had drug refractory ventricular tachycardia, and 10%'o had syncope with heart disease and inducible sustained ventricular tachyarrhyth-mias. The most common types of associated cardiovascular disease were hypertrophic and dilate