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Medline ® Abstract for Reference 38

of 'Wearable cardioverter-defibrillator'

Use of a wearable automated defibrillator in children compared to young adults.
Collins KK, Silva JN, Rhee EK, Schaffer MS
Pacing Clin Electrophysiol. 2010 Sep;33(9):1119-24.
BACKGROUND: A wearable automated external defibrillator has been shown to be efficacious in the prevention of sudden death in adults who had a history of cardiac arrest but who did not have a permanent internal cardioverter/defibrillator (ICD) placed. The use of a wearable defibrillator has not been established in the pediatric population.
METHODS: We retrospectively reviewed the clinical database for the wearable external defibrillator from ZOLL Lifecor Corporation (Pittsburgh, PA, USA). We compared the use of the wearable defibrillator in patients≤18 years of age to those aged 19-21 years.
RESULTS: There were 81 patients≤18 years of age (median age = 16.5 years [9-18]and 52% male). There were 103 patients aged 19-21 years (median age = 20 years [19-21]and 47% male). There was no difference between groups in average hours/day or in total number of days the patients wore the defibrillator. In patients≤18 years of age, there was one inappropriate therapy and one withholding of therapy due to a device-device interaction. In patients aged 19-21 years, there were five appropriate discharges in two patients and one inappropriate discharge in a single patient.
CONCLUSION: It is reasonable to consider the wearable automated external defibrillator as a therapy for pediatric patients who are at high risk of sudden cardiac arrest but who have contraindications to or would like to defer placement of a permanent ICD. As there were no appropriate shocks in our patients≤18 years of age, this study cannot address efficacy of the therapy.
Division of Pediatric Cardiology, The Children's Hospital, University of Colorado, Denver, CO, USA. collins.kathryn@tchden.org