| Institution: | 1. University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA;2. University of Southern California Keck School of Medicine, Los Angeles, CA, USA;3. Washington University in St. Louis, St. Louis, Missouri, USA;4. Oregon Health & Science University, Portland, OR, USA;5. Yale University School of Medicine, New Haven, CT, USA;6. Hospital de Pediatría Juan P. Garrahan, Hospital El Cruce, Hospital Británico de Buenos Aires, Instituto Cardiovascular ICBA, Buenos Aires, Argentina;7. George Washington University, Washington, DC, USA;8. Mayo Clinic, Rochester, MN, USA;9. New York University Grossman School of Medicine, New York, NY, USA;10. Inova Children''s Hospital, Fairfax, VA, USA;11. University of Michigan, Ann Arbor, MI, USA;12. Advocate Children''s Heart Institute, Chicago, IL, USA;13. Heart Centre Leipzig, University of Leipzig, Leipzig, Germany;14. Bristol Royal Hospital for Children, Bristol, United Kingdom;15. Vanderbilt University Medical Center, Nashville, TN, USA;p. University Pediatricians, Children''s Hospital of Michigan, Detroit, MI, USA;q. Baylor College of Medicine, Houston, TX, USA;r. Amrita Institute of Medical Sciences, Kochi, India;s. Children''s Heart Center, Charles University in Prague and Motol University Hospital, Prague, Czech Republic;t. Harvard Medical School, Boston, MA, USA;u. University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA;v. Shizuoka General Hospital and Mt. Fuji Shizuoka Children''s Hospital, Shizuoka, Japan;w. Stanford University, Palo Alto, CA, USA;x. University of Utah Health Sciences Center, Salt Lake City, UT, USA;y. Nicklaus Children''s Hospital, Miami, FL, USA;z. Georg-August-University Medical Center, Göttingen, Germany;11. Evelina London Children''s Hospital and St Thomas'' Hospital, Guy''s & St Thomas'' NHS Foundation Trust, London, United Kingdom;12. St. Luke''s Health System, Boise, ID, USA;13. Bambino Gesù Children''s Hospital IRCCS, Rome, Italy;14. The Hospital for Sick Children, Toronto, Canada;15. New York University Langone Health, New York, NY, USA;16. University of Wisconsin School of Medicine and Public Health, Madison, WI, USA |
| Abstract: | In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients. |
