Pacemaker and Defibrillator Therapy in Pediatrics and Congenital Heart Disease

Abstract

Pacemakers and defibrillators have a growing use in pediatrics and in patients with congenital heart disease, but they present unique problems and implications for their implantation and follow-up. Congenital and surgically acquired rhythm disturbances are common, but the efficacy of device therapy is not well established in these patient groups. The diversity and complexity of pediatric patients and congenital heart disease make device management a highly individualized art. There are technical issues related to device implantation that have necessitated novel approaches to using leads and device that were not designed with children specifically in mind. The current guidelines and indications for implantable device therapy for children and congenital heart disease are reviewed, as well as some of the specific limitations and problems encountered.

Keywords: :

• children
• complications
• congenital heart disease
• implantable cardioverter defibrillator
• pacemaker
• pediatric
• techniques

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

AV: Atrioventricular; CHD: Congenital heart disease; HR: Heart rate; VT: Ventricular tachycardia.

Adapted from [4].

EPS: Electrophysiology study; ICD: Implantable cardioverter defibrillator; LV: Left ventricular; RVOT: Right ventricular outflow tract; SCD: Sudden cardiac death; VF: Ventricular fibrillation; VT: Ventricular tachycardia.

Adapted from [4].