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BACKGROUND Use of implantable cardiac defibrillators (ICDs) in children and patients with congenital heart disease is complicated by body size and anatomy. A variety of creative implantation techniques has been used empirically in these groups on an ad hoc basis. OBJECTIVE To rationalize ICD placement in special populations, we used subject-specific,(More)
OBJECTIVES To examine outcomes of children with pacemakers over a 22-year period and identify risk factors for lead failure. BACKGROUND Small patient size, structural cardiac abnormalities, and growth may complicate pediatric pacemaker management. Better knowledge of risk factors for lead failure in these patients may help improve future outcomes. (More)
BACKGROUND Ablation success rates reported for atrial tachycardia (AT) patients with congenital heart disease (CHD) is lower than the rates reported for other varieties of supraventricular tachycardia. Retrospective studies suggest these rates might be increased by the use of irrigated radiofrequency (RF) ablation. OBJECTIVES The purpose of this study was(More)
BACKGROUND Venous occlusion is a recognized complication of transvenous pacing, and lead cross-sectional area indexed to body surface area (BSA) has been used to predict venous obstruction in children. OBJECTIVE The aim of this study was to identify the risk factors and incidence of angiographic venous obstruction after transvenous lead implantation in(More)
INTRODUCTION An insertable loop recorder (ILR) in patients with infrequent syncope or palpitations may be useful to decide management strategies, including clinical observation, medical therapy, pacemaker, or implantable cardioverter defibrillator (ICD). We sought to determine the diagnostic utility of the Reveal ILR (Medtronic, Inc., Minneapolis, MN, USA)(More)
BACKGROUND Transposition of the great arteries with intra-atrial baffle repair is among the congenital heart defects at highest risk of sudden death. Little is known about mechanisms of sudden death and the role of implantable cardioverter defibrillators. METHODS AND RESULTS We conducted a multicenter cohort study in patients with transposition of the(More)
BACKGROUND Although pulmonary valve replacement (PVR) is effective in reducing right ventricular (RV) volume overload in patients with chronic pulmonary regurgitation, persistent RV dysfunction and subsequent adverse clinical outcomes have been reported. This trial was conducted to investigate whether the addition of surgical RV remodeling with exclusion of(More)
INTRODUCTION In pediatric and congenital heart disease patients, transvenous ICD implantation may be limited secondary to patient size, venous, or cardiac anatomy. Epicardial patches require a thoracotomy, and may lead to a restrictive pericardial process. Because of these issues, we have explored novel ICD configurations. METHODS Retrospective review at(More)
INTRODUCTION The incidence of appropriate and inappropriate discharges, indicators of system failure, and clinical implications of implantable cardioverter defibrillator (ICD) therapy in children and young adults with heart disease is poorly defined. METHODS AND RESULTS In a retrospective study at a single medical center, a total of 90 ICD procedures were(More)
OBJECTIVES Our objective was to evaluate the short-term safety and efficacy of cardiac resynchronization therapy (CRT) in children. BACKGROUND Cardiac resynchronization therapy has been beneficial for adult patients with poor left ventricular function and intraventricular conduction delay. The efficacy of this therapy in the young and in those with(More)