INTRODUCTION:
Advances in technology have increased our ability to utilize implantable
cardioverter defibrillators (ICD) in the young. ICDs are primarily
implanted to provide protection against lethal arrhythmias for children
with inheritable arrhythmia syndromes, congenital heart disease (CHD),
and cardiomyopathies. Increasingly they are being considered among
children with arrhythmias and severe heart failure on ventricular assist
devices. Studies have shown that the use of ICDs as a bridge to
transplantation decreases pre-transplant mortality. Little is known
about the rates of mortality, hospitalizations, or causes of death among
children with ICD implantations. The primary aim of this study was to
evaluate trends in hospital admissions among children with ICDs. Our
secondary aims were to determine hospital mortality rates and to explore
factors associated with in-hospital death. We hypothesized that 1) ICD
related hospitalizations have increased over time and would be higher in
patients with primary cardiomyopathies or congenital heart disease
compared to those with primary arrhythmia disorders and 2) in-hospital
mortality is more likely to be associated with underlying factors such
as congenital heart disease or heart failure.