Department of Pediatrics, The University of Tokyo Hospital.
Ube Kosan Central Hospital.
Circ J. 2018 Dec 25;83(1):52-55. doi: 10.1253/circj.CJ-18-0712. Epub 2018 Oct 20.
Implantable cardioverter defibrillators (ICDs) are being used with increasing frequency in children. Our aim was to examine the current trend of pediatric ICD implantation in Japan.
Data was extracted from the Japanese Cardiac Device Treatment Registry (JCDTR), a nation-wide registry started in 2006. All patients aged less than 18 years who had an ICD implantation registered between 2006 and 2016 were included in the analysis. A total of 201 patients were included, with a median age of 16 years (range 1-18). The underlying cardiac diagnosis was primary electrical disease (67%), cardiomyopathy (26%) and congenital heart disease (4%), with idiopathic ventricular fibrillation (29%) and long QT syndrome (21%) being the 2 most common diagnoses. Implantation indication was primary prevention in only 30 patients (15%). There were 27 patients (13%) aged ≤12 years, with a larger proportion of patients with cardiomyopathy (33%). The indication in younger children was secondary prevention in all cases. Younger children may be under-represented in our study given the nature of the database as it is a predominantly adult cardiology database.
In the past decade, ICD implantation has been performed in approximately 20 children per year in Japan, mostly for secondary prevention. There was no increase in the trend nor a change in age distribution.
植入式心脏复律除颤器（ICD）在儿童中的应用越来越频繁。我们旨在研究日本儿童 ICD 植入的当前趋势。
数据取自日本心脏器械治疗注册（JCDTR），这是一个 2006 年开始的全国性注册。所有年龄小于 18 岁、2006 年至 2016 年期间登记 ICD 植入的患者均纳入分析。共纳入 201 例患者，中位年龄 16 岁（范围 1-18 岁）。基础心脏诊断为原发性电疾病（67%）、心肌病（26%）和先天性心脏病（4%），特发性室性心动过速（29%）和长 QT 综合征（21%）是最常见的两种诊断。仅 30 例（15%）为一级预防植入指征。有 27 例（13%）患者年龄≤12 岁，其中心肌病患者比例较大（33%）。较小年龄组的所有患者均为二级预防指征。鉴于数据库的性质主要为成人心脏病学数据库，因此我们的研究可能低估了儿童患者的比例。
在过去十年中，日本每年约有 20 名儿童接受 ICD 植入，主要用于二级预防。趋势没有增加，年龄分布也没有变化。
