Children’s National Researchers Contribute to Major Study Evaluating Implantable Defibrillators in Children
June 18, 2013
Washington, DC—Implantable cardioverter-defibrillator (ICD) treatment for children and young adults is limited by the short lifespan of the leads—wires that connect the device to specific places in the heart—according to a major international study.
The five-and-a-half-year study followed 878 patients with ICD lead implants, from the international Pediatric Lead Extractability and Survival Evaluation (PLEASE) registry. ICD leads failed in 15 percent of patients, at an average of two years after being implanted. Extractions were performed on 143 leads, with six major complications but no procedure-related deaths. The findings, released early online, will be published in the June 18, 2013, edition of the American Heart Association’s flagship journal, Circulation.
Researchers from Children’s National Medical Center played a key role in the 24-center study, which is the largest yet to examine outcomes of ICD leads in children and congenital heart disease (CHD) patients.
The authors note, “One important and modifiable clinical variable that emanates from this study is the increased risk of lead failure with younger age at implant.”
As the medical indications have expanded for use of ICDs in children and CHD patients, and manufacturers have developed smaller devices, the number of young patients with ICDs is rising. Younger patients often outlive their ICD leads or outgrow the length of the leads, so the leads must be replaced or removed, a challenging procedure with substantial risks.
“ICDs offer a crucial therapy option for children and for young adults with CHD, but lead performance remains a challenge, as our findings show,” said the study’s senior author, Charles I. Berul, MD, Chief of Cardiology for Children’s National Medical Center. “The need for repeated high-risk lead extractions tells us that better lead durability and extractability for the youngest ICD recipients is a top priority.”
In addition to Dr. Berul, other study authors from Children’s National were Vicki Freedenberg, PhD, RN, MSN, and Marcin Gierdalski, PhD.
Dr. Berul is an acknowledged expert in pediatric cardiac electrophysiology, which diagnoses and treats arrhythmias. Before he joined Children’s National in 2009, he was Director of the Pacemaker Program at Boston Children’s Hospital, an affiliate of Harvard Medical School. He is the 2013-2014 President of the Pediatric and Congenital Electrophysiology Society. Dr. Berul is a fellow of the Heart Rhythm Society, the American Academy of Pediatrics, the American College of Cardiology, the Society for Pediatric Research, and the American Heart Association’s Council on Cardiovascular Disease in the Young. He has more than 150 publications in pediatric cardiology to his name and is frequently an invited speaker nationally and internationally.
Contact: Emily Hartman or Paula Darte, 202-476-4500