Wearable Cardioverter Defibrillators Safe, Effective for Pediatric Patients

Wearable cardioverter defibrillators are safe and effective for pediatric patients at risk for sudden cardiac death (SCD), according to research presented at the Heart Rhythm Society’s 38th Annual Scientific Sessions, May 10-13, in Chicago, Illinois.¹

This study represents the largest pediatric population to be evaluated for wearable cardioverter defibrillator therapy to date.

A total of 455 patients (median age, 15 years) wore a wearable cardiac defibrillator for at least 1 day between 2009 and 2016. Common diagnoses for treatment with a wearable cardiac defibrillator included cardiomyopathy, congenital heart disease, ventricular arrhythmias, channelopathy, and history of prior cardiac arrest without any other diagnosis.

At least 1 shock treatment was delivered to 8 patients (1.8%); 2 patients received 1 inappropriate treatment each (asystole and artifact). In 6 patients who received appropriate treatment, there were 7 episodes of either polymorphic ventricular tachycardia or ventricular fibrillation, with a total of 13 treatments. All episodes were successfully converted, and there were no patient deaths.

In 195 patients, the wearable cardioverter defibrillators were discontinued for implantable cardioverter defibrillator placement. In addition, 20 patients had heart transplantation and 67 patients had the wearable cardioverter defibrillators removed for improvement of ejection fraction. There were 7 deaths among the patients who discontinued use, all of which occurred when they were no longer wearing the wearable cardioverter defibrillator.

“The results are comparable to that of the adult population who use wearable defibrillators and provides reassurance that we can consider this to be an effective therapy enabling young patients to leave the hospital and return to their daily activities,” David Spar, MD, lead author and assistant professor at the University of Cincinnati Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, said in a Heart Rhythm Society press release.²

References

1. Spar DS, Knilans TK, Czosek RJ, Bianco NR, Anderson JB. The US experience of the wearable cardioverter-defibrillator in pediatric patients. Presented at: Heart Rhythm Society’s 38th Annual Scientific Sessions. May 10-13, 2017; Chicago, Illinois.
2. Wearable cardioverter defibrillators prove to be safe for pediatric patients at risk for sudden cardiac arrest [press release]. Chicago, IL: Heart Rhythm Society; May 11, 2017.