Background:Implantable cardioverter-defibrillator (ICD) therapy is important for the prevention of sudden cardiac death, but data on clinical outcomes of ICD therapy in Asian pediatric patients are scarce. The aim of this Korean multicenter study was to evaluate the current state and elucidate the clinical outcomes of ICD therapy in children.

Methods and Results:Data from 5 pediatric cardiology centers were retrospectively collected from 2007 to 2019. Altogether, 99 patients were enrolled (mean age 13.9±4.1 years). The most common underlying disease was a primary electrical disease (56%). An ICD was implanted for primary prevention in 19%. Appropriate shock occurred in 44% of patients at a median of 1.6 years after implantation. There was no significant difference in the appropriate shock rate between patients with primary and secondary prevention indications (32% vs. 48%, respectively). A total of 33 patients (33%) experienced inappropriate shock, which was associated with primary electrical disease and follow-up duration on multivariate analysis. 17% of patients had ICD-related complications.

Conclusions:The utilization rate of ICD for primary prevention was still low in the pediatric population in Korea, but there was a substantial rate of appropriate shock in these patients. Efforts to increase ICD usage to save the lives of high-risk patients and reduce the incidence of inappropriate shock are required.

背景：植入式心脏复律除颤器 (ICD) 治疗对于预防心源性猝死很重要，但亚洲儿科患者 ICD 治疗临床结果的数据很少。这项韩国多中心研究的目的是评估儿童 ICD 治疗的现状并阐明其临床结果。

方法与结果：回顾性收集 2007 年至 2019 年来自 5 个儿科心脏病中心的数据。共纳入 99 名患者（平均年龄 13.9±4.1 岁）。最常见的潜在疾病是原发性电疾病（56%）。19% 的患者植入 ICD 进行一级预防。44% 的患者在植入后的中位时间为 1.6 年时发生了适当的休克。具有一级和二级预防指征的患者的适当休克率无显着差异（分别为 32% 和 48%）。多变量分析显示，共有 33 名患者 (33%) 经历了不适当的电击，这与原发性电疾病和随访时间有关。17% 的患者有 ICD 相关并发症。

结论：在韩国儿科人群中，ICD 用于一级预防的利用率仍然较低，但在这些患者中适当休克的比例很高。需要努力增加 ICD 的使用以挽救高危患者的生命并减少不当休克的发生率。