Jani Thuraiaiyah, Annette Schophuus Jensen, Ole De Backer, Chee Woon Lim, Lars Idorn, Frederikke Noerregaard Jakobsen, Troels Hoejsgaard Joergensen, Michael Rahbek Schmidt, Morten Smerup, Jens Brock Johansen, Sam Riahi, Lars Sondergaard, Jens Cosedis Nielsen, Berit Thornvig Philbert, Christian Jons
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引用次数: 0
Abstract
Background: Cardiac implantable electronic devices (CIED) can be implanted epicardial or transvenous in children. Both techniques involve procedure-specific complications, and the evidence is scares for which technique to choose for different ages.
Objectives: We aimed to characterize a complete national pediatric cohort with a de-novo CIED implantation and compare the risk and causes of re-intervention between transvenous and epicardial CIED recipients.
Methods: This retrospective nationwide cohort study included all Danish children receiving a CIED aged≤15 years from 1977 to 2021. The outcomes included time to first re-intervention stratified by age and implantation technique. Re-intervention was either due to battery depletion, lead- or generator complication.
Results: A total of 376 children received epicardial (n=131, 35%) and transvenous (n=245, 65%) CIEDs with a median follow-up of 14 (IQR 6-21) years. Median age was 6 (IQR 1-11) years. For epicardial recipients, the complication-driven re-intervention was equal across age groups (p=0.10), while among transvenous recipients, the risk was significantly lower with increasing age (p<0.001). Age-specific risk analyses revealed different risks for children aged <1 year, 1-8 years, and 9-15 years (Pinteraction<0.001). For children<1 year, a complication-driven re-intervention was more frequent for transvenous versus epicardial recipients (p<0.001), while in children aged 9-15 years, the opposite was observed (p=0.02).
Conclusions: Transvenous implantation in children <1 year and epicardial implantation in children 9-15 years were associated with higher risk of CIED-related complication leading to re-intervention, whereas for children aged 1 to 8 years, complication risk was similar between implantation techniques.
期刊介绍：
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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