[SCD-FORUM] 83E RE: ICD implantation in children. Dr. Peter Scwartz to Dr. Didier Klug

[SCD Symposium]

I could not agree more. The complexities and rate of complications  
with ICD
implants in children are such to make not justifiable this approach, for
LQTS patients, unless there has been a cardiac arrest or very special
circumstances. It should not be forgotten that the combined incidence of
CA/SD for LQT1 patients (mean follow-up 12 years) is 1.2%. LQT1 pts with
syncope don't need an ICD. And LQT2 pts have an incidence of 7% (all  
CA, in
our 2 series). What is necessary is to explain carefully to the families
the pro and cons and the actual risks, and then help them to decide.  
This,
however, takes time. And this is what a good physician should do.
Peter J. Schwartz

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee

>
> ICD implantation in children is a major problem. The first problem  
> is the implantation of the ICD lead inside the right ventricle with  
> coil unfitted for the size of the cavity and development of  
> adherences between the coil and the tricuspid valve. In this  
> population we will have to extract these leads during the FU of  
> these patients and in our experience this extraction is challenging  
> even on recent leads. Hence, we have recently used the technique  
> describe by GASPARINI et al (J Cardiovasc Electrophysiol, Vol. 16,  
> pp. 1381-1383) with a coil in the inferior vena-cava. What is your  
> experience with this technique?
>
> Didier Klug, MD, PhD
> Hôpital cardiologique de Lille
> University of Lille
> France
>

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