Silka Michael J, Shah Maully J, Avari Silva Jennifer N, Balaji Seshadri, Beach Cheyenne M, Benjamin Monica N, Berul Charles I, Cannon Bryan, Cecchin Frank, Cohen Mitchell I, Dalal Aarti S, Dechert Brynn E, Foster Anne, Gebauer Roman, Gonzalez Corcia M Cecilia, Kannankeril Prince J, Karpawich Peter P, Kim Jeffery J, Krishna Mani Ram, Kubuš Peter, LaPage Martin J, Mah Douglas Y, Malloy-Walton Lindsey, Miyazaki Aya, Motonaga Kara S, Niu Mary C, Olen Melissa, Paul Thomas, Rosenthal Eric, Saarel Elizabeth V, Silvetti Massimo Stefano, Stephenson Elizabeth A, Tan Reina B, Triedman John, Von Bergen Nicholas H, Wackel Philip L
University of Southern California Keck School of Medicine, Los Angeles, California, USA.
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Indian Pacing Electrophysiol J. 2021 Nov-Dec;21(6):349-366. doi: 10.1016/j.ipej.2021.07.006. Epub 2021 Jul 29.
Guidelines for the implantation of cardiac implantable electronic devices (CIEDs) have evolved since publication of the initial ACC/AHA pacemaker guidelines in 1984 [1]. CIEDs have evolved to include novel forms of cardiac pacing, the development of implantable cardioverter defibrillators (ICDs) and the introduction of devices for long term monitoring of heart rhythm and other physiologic parameters. In view of the increasing complexity of both devices and patients, practice guidelines, by necessity, have become increasingly specific. In 2018, the ACC/AHA/HRS published Guidelines on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay [2], which were specific recommendations for patients >18 years of age. This age-specific threshold was established in view of the differing indications for CIEDs in young patients as well as size-specific technology factors. Therefore, the following document was developed to update and further delineate indications for the use and management of CIEDs in pediatric patients, defined as ≤21 years of age, with recognition that there is often overlap in the care of patents between 18 and 21 years of age. This document is an abbreviated expert consensus statement (ECS) intended to focus primarily on the indications for CIEDs in the setting of specific disease/diagnostic categories. This document will also provide guidance regarding the management of lead systems and follow-up evaluation for pediatric patients with CIEDs. The recommendations are presented in an abbreviated modular format, with each section including the complete table of recommendations along with a brief synopsis of supportive text and select references to provide some context for the recommendations. This document is not intended to provide an exhaustive discussion of the basis for each of the recommendations, which are further addressed in the comprehensive PACES-CIED document [3], with further data easily accessible in electronic searches or textbooks.
自1984年最初的美国心脏病学会（ACC）/美国心脏协会（AHA）起搏器指南发布以来，心脏植入式电子设备（CIED）的植入指南不断演变[1]。CIED已发展到包括新型心脏起搏形式、植入式心律转复除颤器（ICD）的开发以及用于长期监测心律和其他生理参数的设备。鉴于设备和患者的复杂性日益增加，实践指南必然变得越来越具体。2018年，ACC/AHA/心律学会（HRS）发布了《心动过缓和心脏传导延迟患者的评估和管理指南》[2]，这是针对18岁以上患者的具体建议。鉴于年轻患者CIED的不同适应证以及特定尺寸的技术因素，设定了这个特定年龄阈值。因此，制定了以下文件，以更新并进一步阐述CIED在定义为≤21岁的儿科患者中的使用和管理适应证，同时认识到18至21岁患者的护理往往存在重叠。本文件是一份简化的专家共识声明（ECS），主要旨在关注特定疾病/诊断类别中CIED的适应证。本文件还将为CIED儿科患者的导线系统管理和随访评估提供指导。建议以简化的模块化格式呈现，每个部分包括完整的建议表以及支持性文本的简要概述和精选参考文献，以为建议提供一些背景信息。本文件无意对每项建议的依据进行详尽讨论，这些内容在全面的《儿科心脏电生理学会-心脏植入式电子设备》文件[3]中有进一步阐述，更多数据可通过电子搜索或教科书轻松获取。
