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.

鉴于当前时代心血管植入式电子设备 (CIED) 和患者的复杂性日益增加，实践指南必然变得越来越具体。本文件是一份专家共识声明，旨在更新和进一步描述儿童患者（定义为 21 岁）的 CIED 适应症和管理，旨在主要关注特定疾病中 CIED 的适应症类别。该文件还强调了先前发布的成人和儿童 CIED 建议之间的差异，并为潜在的重要差异提供了理由。该文件阐述了中低收入国家使用 CIED 的一些障碍以及规避这些障碍的策略。文件部分由编写委员会成员根据他们的专业知识进行划分和起草。推荐意见代表整个写作委员会的共识意见，按推荐等级和证据水平分级。本文件中解决的几个问题要么不适用于临床试验，要么属于罕见病实体，在这些情况下，建议基于专家共识。此外，即使有大量数据支持，具体建议也不能取代对临床判断和患者特定决策的需求。这些建议已向儿科和先天性电生理学会 (PACES) 成员开放征求公众意见，并由心律学会 (HRS) 的科学和临床文件委员会进行外部审查，美国心脏协会 (AHA)、美国心脏病学会 (ACC) 和欧洲儿科和先天性心脏病学会 (AEPC) 的科学咨询和协调委员会。该文件得到了所有合作者和亚太心律协会 (APHRS)、印度心律协会 (IHRS) 和拉丁美洲心律协会 (LAHRS) 的认可。本文件有望为临床医生和患者提供支持，以便在儿科患者中进行适当的 CIED 使用、适当的 CIED 管理和适当的 CIED 随访。该文件得到了所有合作者和亚太心律协会 (APHRS)、印度心律协会 (IHRS) 和拉丁美洲心律协会 (LAHRS) 的认可。该文件有望为临床医生和患者提供支持，以便在儿科患者中进行适当的 CIED 使用、适当的 CIED 管理和适当的 CIED 随访。该文件得到了所有合作者和亚太心律协会 (APHRS)、印度心律协会 (IHRS) 和拉丁美洲心律协会 (LAHRS) 的认可。该文件有望为临床医生和患者提供支持，以便在儿科患者中进行适当的 CIED 使用、适当的 CIED 管理和适当的 CIED 随访。