Internal defibrillators don't benefit children waiting for a heart transplant

10th August 2015

Children waiting for a heart transplant are seldom at risk of a cardiac arrest so do not benefit from having an internal defibrillator, says a study from America.

Implantable cardioverter defibrillators (ICDs) are known to reduce the risk of a cardiac arrest in adults with severe heart failure; but whether they should be used in children waiting for a heart transplant had not been established, said the researchers.

heart transplant

So the study, led by Dr Iqbal El-Assaad, from the pediatrics department at Cleveland Children’s Clinic in Ohio, and Dr Sadeer G. Al-Kindi, from the advanced heart failure centre at Harrington Heart & Vascular Institute, also in Cleveland, investigated the role of ICDs in preventing death in children listed for heart transplant.

They used information from the United Network for Organ Sharing (UNOS) database for all patients aged 18 or under listed for heart transplants between 2005 and 2014.

The list of 5,072 children with a mean age of just over six included ones with myocarditis (inflammation of the heart muscle), restrictive cardiomyopathy and dilated cardiomyopathy. A total of 426 (8.3 per cent) of the children had an ICD at the time of listing.

At six months 65 per cent had had their transplants. Fifteen per cent had died (four per cent had died suddenly) and 20 per cent were living. But having an ICD did not improve survival.

The researchers concluded that the risk of sudden death remained low in these children and did not differ between those with or without an ICD at listing.