AI Article Synopsis
- - The study analyzed data from the EUROMACS database focusing on children under 19 years old who were supported by ventricular assist devices (VAD) and assessed the impact of having an implantable cardioverter-defibrillator (ICD) at the time of VAD placement.
- - Out of 303 patients, only 7% had an ICD, and the analysis revealed that while 77% of these children were eventually transplanted, there was no significant difference in overall survival rates between those with an ICD and those without.
- - The presence of an ICD did not confer a survival advantage in pediatric patients on VAD support, indicating that the benefit of this device in this context may be limited.
Article Abstract
Background: Data on the use and outcome of children on ventricular assist device (VAD) support provided with an implantable cardioverter-defibrillator (ICD) remains poor.
Methods: A retrospective analysis of the EUROMACS database on children supported with VAD < 19 years of age from January 1, 2009 to April 1, 2020. Patients with missing data on status of ICD, missing baseline and/or follow up information were excluded. The primary independent variable of interest was the concomitant presence or absence of an ICD at the time of VAD placement. Kaplan-Meier survival analysis was performed to evaluate survival differences between children on VAD with and without an ICD.
Results: Out of 303 patients provided with a VAD, 7% (7♀, 15♂) had an ICD implanted and formed the study group. Median age was 14 years, median weight was 43.5 kg, and median BSA was 1.39. Median Intermacs stage was 2 (range: 1-7). Seventeen patients (77%) were transplanted, 4 (18%) died while on support, and 1 (5%) was weaned from device after myocardial recovery. Median time on support was 68 days compared to 361 days in the control group (p: 0.01). Three patients underwent device exchange due to thrombus formation in the pump. There was no difference in survival between groups (p = 0.342).
Conclusion: The presence of ICD in pediatric patients supported with a VAD is low (7%). Children on VAD support provided with an ICD do not have a survival benefit compared to children without an ICD.
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| http://dx.doi.org/10.1111/aor.14515 | DOI Listing |
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