Implant and clinical characteristics for pediatric and congenital heart patients in the NCDR ICD registry

Background —In 2010 the NCDR Registry® enhanced pediatric, non-atherosclerotic structural heart disease and congenital heart disease (CHD) data collection. This report characterizes CHD and pediatric patients undergoing implantable cardioverter-defibrillator (ICD) implantation. Methods and Results —ICD procedures (April 2010 - December 2012) in the Registry for two cohorts: 1) all CHD patients (atrial septal defect (ASD), ventricular septal defect (VSD), Tetralogy of Fallot (ToF), Ebstein anomaly, transposition of the great vessels (TGV), and common ventricle (CV)), and 2) patients under 21 years. We evaluated indications and characteristics to include transvenous (TV) and non-TV lead implants, CHD type, and NYHA class. There were 3,139 CHD procedures, 1,601 for patients under 21 years and 126 for CHD under 21 years. ICD indications for CHD patients were primary prevention in 1,943 (61.9%) and secondary prevention in 1,107 (35.2%). Pediatric patients had 935 (58.4%) primary prevention and 588 (36.7%) secondary prevention devices. Primary prevention had higher NYHA class. Non-TV age (35.9 ± 23.2 years vs. 40.1 ± 24.6 years; p= 0.05) and Non-TV height (167.1 ± 18.9 cm; range 53-193 cm; vs. 170.4 ± 13.1 cm; range 61-203 cm; p<0.01) were lower than for TV patients. CHD and pediatrics had similar rates of TV (97%) and non-TV (3%) leads and did not differ from the overall registry. TGV and common ventricle had higher rates of non-TV leads. Conclusions —Primary prevention exceeds secondary prevention for CHD and pediatrics. Non-TV lead patients were younger, with higher rates of TGV and CV patients compared to TV lead patients.