Inferior vena cava loop of the implantable cardioverter defibrillator endocardial lead: A possible solution to the growth problem in pediatric implantation

Maurizio Gasparini, Massimo Mantica, Paola Galimberti, Fernando Coltorti, Carlo Ceriotti, Silvia G. Priori

Research output: Contribution to journalArticlepeer-review

Abstract

The ICD is an important treatment option in adults and children with life-threatening tachyarrhythmias. The possibility of lead displacement caused by growth and the lack of dedicated leads and devices poses special problems in pediatric ICD implantation. We describe our experience in three children in whom we left a redundant lead loop within the inferior vena cava (IVC) to allow for further growth. Since February 1998, three children underwent ICD implantation at our institution. A lead (screw-in) was advanced into the right ventricular apex, and a loop was created in the IVC by progressively withdrawing the stylet and pushing in the lead. Satisfactory sensing and pacing threshold values were obtained and a successful single 16-J defibrillation test was performed. No complications were encountered. After a mean follow-up of 16 months, with a mean increase in body weight and height of 4.1 ± 0.5 Kg and 6.3 ± 0.4 cm, respectively, chest X ray showed some release of additional lead length, in the absence of dislodgments, while significant changes in pacing/sensing parameters were not found. In conclusion, the creation of a loop within the IVC allows the lead to adjust for growth in children receiving an ICD. This approach is feasible and safe.

Original languageEnglish
Pages (from-to)2108-2112
Number of pages5
JournalPACE - Pacing and Clinical Electrophysiology
Volume23
Issue number12 I
Publication statusPublished - 2000

Keywords

  • Endocardial leads
  • Implantable cardioverter defibrillator
  • Long QT syndrome
  • Pediatric pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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