부산대학교 도서관

Introduction: The implantable cardioverter defibrillator (ICD) has been demonstrated to successfully prevent sudden cardiac death (SCD) in children and young adults. A wide range of device‐related complications/malfunctions have been described, which depend on the intrinsic design of the defibrillation system (transvenous‐implantable cardioverter defibrillator [TV‐ICD] vs. subcutaneous‐implantable cardioverter defibrillator [S‐ICD]). Objective: To compare the device‐related complications and inappropriate shocks with TV‐ICD versus S‐ICD. Methods and Results: Electronic databases were queried for studies focusing on the prevention of SCD in children and young adults with TV‐ICD or S‐ICD. The effect size was estimated using a random‐effect model as odds ratio (OR) and relative 95% confidence interval (CI). The primary endpoint was a composite of any device‐related complications and inappropriate shocks. We identified a total of five studies including 236 patients (Group S‐ICD: 76 patients; Group TV‐ICD: 160 patients) with a mean follow‐up time of 54.2 ± 24.9 months. S‐ICD implantation contributed to a significant reduction in the risk of the primary endpoint of any device‐related complications and inappropriate shocks (OR: 0.18; 95% CI: 0.05–0.73; p =.02). S‐ICD was also associated with a significantly lower incidence of inappropriate shocks (OR: 0.28; 95% CI: 0.11–0.74; p =.01) and lead‐related complications (OR: 0.18; 95% CI: 0.05–0.66; p =.01). A trend toward a higher risk of pocket complications (OR: 5.91; 95% CI: 0.98–35.63; p =.05) was recorded in patients with S‐ICD. Conclusion: Children and young adults undergoing S‐ICD implantation may have a lower risk of a composite of device‐related complications and inappropriate shocks, compared to TV‐ICD patients. [ABSTRACT FROM AUTHOR]