Arrhythmias & electrophysiologyCohort study
Evolution of implantable cardioverter–defibrillator shock therapy in children in the era of optimized implantable cardioverter defibrillator (ICD) programming and remote monitoring
- Retrospective cohort study
- multicentre
Authors' conclusion
The incidence of ICD shocks has significantly decreased in children with implantation after 2010, which appears to be multifactorial.
Study context
- Population
- Children with transvenous or epicardial ICD implantationmedian follow-up 5.2 years
- Participants
- 116 children
- Exposure
- ICD implantation after 2010 vs before 2010
- After 2010n = 63
- Before 2010n = 53reference
- Outcome
- ICD shocks (total, appropriate, inappropriate annual shock rate)
Main finding
As reported in the abstract
Annual shock rate
Total shocks
P = 0.008
Appropriate shocks
P = 0.036
Inappropriate shocks
P = 0.28
Observational data: associations, not effects.
Further findings
Remote monitoring and shocks
- Remote monitoring associated with decrease in total shocks (mean cumulative function (MCF))
- P = 0.013
- Remote monitoring associated with decrease in appropriate shocks (MCF)
- P = 0.052
Ventricular fibrillation (VF) zone programmed ≥210 bpm
- At appropriate vs inappropriate shocks: 86 vs. 79%
- P = 0.0016
- After vs before 2010: 90 vs. 76% (no significant change)
- P = 0.142
- Patients with vs without shocks: 79 vs. 89%
- P = 0.243
Cardiac-related death
- No increase in cardiac-related death
Original publication
Evolution of implantable cardioverter–defibrillator shock therapy in children in the era of optimized ICD programming and remote monitoring. Europace. Published 29 September 2025. doi:10.1093/europace/euaf240
Summarised from the published abstract; every number is checked against it