Adäquate und inadäquate Schockabgaben implantierbarer Kardioverter- Defibrillatoren bei Kindern, Jugendlichen und Patienten mit einem angeborenen Herzfehler

Wilberg, Yannic

dc.contributor.advisor	Krause, Ulrich PD Dr.
dc.contributor.author	Wilberg, Yannic
dc.date.accessioned	2021-02-11T08:48:59Z
dc.date.available	2021-02-24T23:50:03Z
dc.date.issued	2021-02-11
dc.identifier.uri	http://hdl.handle.net/21.11130/00-1735-0000-0005-1569-E
dc.identifier.uri	http://dx.doi.org/10.53846/goediss-8425
dc.identifier.uri	http://dx.doi.org/10.53846/goediss-8425
dc.language.iso	deu	de
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc	610	de
dc.title	Adäquate und inadäquate Schockabgaben implantierbarer Kardioverter- Defibrillatoren bei Kindern, Jugendlichen und Patienten mit einem angeborenen Herzfehler	de
dc.type	doctoralThesis	de
dc.title.translated	Appropriate and Inappropriate ICD Shocks in Children, Adolescents, and Adults with Congenital Heart Disease	de
dc.contributor.referee	Krause, Ulrich PD Dr.
dc.date.examination	2021-02-17
dc.description.abstracteng	In pediatric cardiology and cardiology of adults with congenital heart disease, indication for implantation of an implantable cardioverter-defibrillator (ICD) is often based on underlying diseases like primarily electrical heart disease (channelopathies), cardiomyopathies or congential heart disease. Implantation of a conventional transvenous system may be impossible in small children or patients with complex cardiac anatomy (e. g. after Glenn procedure). In the clinic of pediatric cardiology and intensive care medicine, non-transvenous ICD systems with a tailored follow up program are established as an alternative. Appropriate and inappropriate ICD discharges are negatively correlated with patient’s quality of life. Aim of this single center retrospective study was to report the medical history of a large number of children, adolescents and adults with congenital heart disease after implantation of an ICD. Particular attention was paid to the occurrence of appropriate and inappropriate ICD discharges. Factors associated with appropriate and inappropriate ICD discharges should be identified. Furthermore, the above-mentioned non-transvenous ICD systems were compared with conventional transvenous ICD systems in terms of their safety and effectiveness. Data showed that antitachycardia pacing is effective tool for prevention of appropriate ICD discharge. Patients with primarily electrical heart disease experience appropriate ICD discharge early after implantation, so that special emphasis should be placed on rapid invasive and non-invasive therapy in addition to the implantation of an ICD. Appropriate ICD discharge was rare in patients with congenital heart disease and indication for ICD implantation for primary prevention. Most common cause for inappropriate ICD discharge was supraventricular or atrial tachycardia. Rigorous, possibly invasive treatment therefor is mandatory to prevent inappropriate ICD discharge. Implantation of an atrial lead seems to be of minor importance. Rather, the programming of a low VT detection rate seems to be associated with an increased number of inappropriate shocks due to supraventricular or atrial tachycardia. Regarding inappropriate shocks, non-transvenous ICD systems are not inferior to transvenous systems, though the number of lead dysfunction was higher in non-transvenous systems. In conclusion effectiveness of the used follow-up program with regular defibrillation threshold testing can be assumed. The importance of follow-up care by pediatric cardiologists / electrophysiologists trained in the specific aspects of non-transvenous ICD systems is underlined.	de
dc.contributor.coReferee	Zabel, Markus Prof. Dr.
dc.contributor.thirdReferee	Schön, Margarete Prof. Dr.
dc.subject.eng	pediatric cardiology	de
dc.subject.eng	rhythmology	de
dc.subject.eng	Implantable cardioverter-defibrillator	de
dc.subject.eng	congenital heart disease	de
dc.subject.eng	inappropriate ICD discharge	de
dc.subject.eng	non-transvenous ICD system	de
dc.subject.eng	channelopathy	de
dc.identifier.urn	urn:nbn:de:gbv:7-21.11130/00-1735-0000-0005-1569-E-3
dc.affiliation.institute	Medizinische Fakultät	de
dc.subject.gokfull	Medizin (PPN619874732)	de
dc.subject.gokfull	Pädiatrie / Neonatologie / Kinderchirurgie - Allgemein- und Gesamtdarstellungen (PPN619876093)	de
dc.description.embargoed	2021-02-24
dc.identifier.ppn	1748129902

Files in this item

Name:WilbergICDSchockabgabenKinderEMAH.pdf

Size:1.220Mb

Format:PDF

View/Open

Name:: WilbergICDSchockabgabenKinderE ...
Size:: 1.220Mb
Format:: PDF

View/Open

This item appears in the following Collection(s)

Human- und Zahnmedizin [2872]

Show simple item record