Impact of manufacturer advisories and FDA recalls of implantable cardioverter defibrillator generators in pediatric and congenital heart disease patients

Tarun Mahajan, Anne M. Dubin, Dianne L. Atkins, David J. Bradley, Kevin M. Shannon, Christopher C Erickson, Wayne H. Franklin, Frank Cecchin, Charles I. Berul

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Impact of Manufacturer Advisories and FDA Recalls of ICD Generators. Introduction: Recalls of implantable cardioverter defibrillator (ICD) generators have affected many patients. No information is available regarding the impact specifically on pediatric and congenital heart disease (CHD) patients. This study was undertaken to determine implications of ICD manufacturers' advisories and recalls on children and CHD patients. Methods: The first part of this study involved single-center review of patients who underwent ICD placement between 2000 and 2005. Patients with ICDs affected by the 2005 advisories/recalls were reviewed for incidence of explantation, malfunction and complications. Secondly, members of the Pediatric and Congenital Electrophysiology Society (PACES) were queried for patients with affected devices, incidences of explantation, malfunction, and explant-related complications. Data were pooled for aggregate summary. Results: Among 233 patients who underwent ICD implantation at our institution during the study period, 58 (25%) patients had advisory/recalled devices and 13 of 58 (22%) underwent explantation following 3.1 ± 1.3 years implant duration. No defects were identified by the manufacturer. No patients experienced complications requiring reintervention or rehospitalization. Questionnaire responses were received from 22 PACES institutions, included 177 patients with affected devices, of which 76 (43%) were removed. One patient died from complications following revision, and 1 patient had complications requiring reoperation. Two explanted devices had loose headers; no other defects were discovered. Taken together, 2 of 89 explanted devices were defective, and 2 complications occurred from explantation. Conclusions: Advisories and recalls affect substantial numbers of pediatric and CHD patients. A significant proportion underwent explantation. Although complications are infrequent, there are important medical, psychosocial, and financial impacts associated with ICD replacement.

Original languageEnglish (US)
Pages (from-to)1270-1274
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume19
Issue number12
DOIs
StatePublished - Dec 1 2008

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Implantable Defibrillators
Heart Diseases
Pediatrics
Equipment and Supplies
Electrophysiology
Incidence
Reoperation

Keywords

  • Arrhythmia
  • Congenital heart disease
  • Implantable defibrillator
  • Pediatrics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Impact of manufacturer advisories and FDA recalls of implantable cardioverter defibrillator generators in pediatric and congenital heart disease patients. / Mahajan, Tarun; Dubin, Anne M.; Atkins, Dianne L.; Bradley, David J.; Shannon, Kevin M.; Erickson, Christopher C; Franklin, Wayne H.; Cecchin, Frank; Berul, Charles I.

In: Journal of Cardiovascular Electrophysiology, Vol. 19, No. 12, 01.12.2008, p. 1270-1274.

Research output: Contribution to journalArticle

Mahajan, Tarun ; Dubin, Anne M. ; Atkins, Dianne L. ; Bradley, David J. ; Shannon, Kevin M. ; Erickson, Christopher C ; Franklin, Wayne H. ; Cecchin, Frank ; Berul, Charles I. / Impact of manufacturer advisories and FDA recalls of implantable cardioverter defibrillator generators in pediatric and congenital heart disease patients. In: Journal of Cardiovascular Electrophysiology. 2008 ; Vol. 19, No. 12. pp. 1270-1274.
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abstract = "Impact of Manufacturer Advisories and FDA Recalls of ICD Generators. Introduction: Recalls of implantable cardioverter defibrillator (ICD) generators have affected many patients. No information is available regarding the impact specifically on pediatric and congenital heart disease (CHD) patients. This study was undertaken to determine implications of ICD manufacturers' advisories and recalls on children and CHD patients. Methods: The first part of this study involved single-center review of patients who underwent ICD placement between 2000 and 2005. Patients with ICDs affected by the 2005 advisories/recalls were reviewed for incidence of explantation, malfunction and complications. Secondly, members of the Pediatric and Congenital Electrophysiology Society (PACES) were queried for patients with affected devices, incidences of explantation, malfunction, and explant-related complications. Data were pooled for aggregate summary. Results: Among 233 patients who underwent ICD implantation at our institution during the study period, 58 (25{\%}) patients had advisory/recalled devices and 13 of 58 (22{\%}) underwent explantation following 3.1 ± 1.3 years implant duration. No defects were identified by the manufacturer. No patients experienced complications requiring reintervention or rehospitalization. Questionnaire responses were received from 22 PACES institutions, included 177 patients with affected devices, of which 76 (43{\%}) were removed. One patient died from complications following revision, and 1 patient had complications requiring reoperation. Two explanted devices had loose headers; no other defects were discovered. Taken together, 2 of 89 explanted devices were defective, and 2 complications occurred from explantation. Conclusions: Advisories and recalls affect substantial numbers of pediatric and CHD patients. A significant proportion underwent explantation. Although complications are infrequent, there are important medical, psychosocial, and financial impacts associated with ICD replacement.",
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AU - Mahajan, Tarun

AU - Dubin, Anne M.

AU - Atkins, Dianne L.

AU - Bradley, David J.

AU - Shannon, Kevin M.

AU - Erickson, Christopher C

AU - Franklin, Wayne H.

AU - Cecchin, Frank

AU - Berul, Charles I.

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AB - Impact of Manufacturer Advisories and FDA Recalls of ICD Generators. Introduction: Recalls of implantable cardioverter defibrillator (ICD) generators have affected many patients. No information is available regarding the impact specifically on pediatric and congenital heart disease (CHD) patients. This study was undertaken to determine implications of ICD manufacturers' advisories and recalls on children and CHD patients. Methods: The first part of this study involved single-center review of patients who underwent ICD placement between 2000 and 2005. Patients with ICDs affected by the 2005 advisories/recalls were reviewed for incidence of explantation, malfunction and complications. Secondly, members of the Pediatric and Congenital Electrophysiology Society (PACES) were queried for patients with affected devices, incidences of explantation, malfunction, and explant-related complications. Data were pooled for aggregate summary. Results: Among 233 patients who underwent ICD implantation at our institution during the study period, 58 (25%) patients had advisory/recalled devices and 13 of 58 (22%) underwent explantation following 3.1 ± 1.3 years implant duration. No defects were identified by the manufacturer. No patients experienced complications requiring reintervention or rehospitalization. Questionnaire responses were received from 22 PACES institutions, included 177 patients with affected devices, of which 76 (43%) were removed. One patient died from complications following revision, and 1 patient had complications requiring reoperation. Two explanted devices had loose headers; no other defects were discovered. Taken together, 2 of 89 explanted devices were defective, and 2 complications occurred from explantation. Conclusions: Advisories and recalls affect substantial numbers of pediatric and CHD patients. A significant proportion underwent explantation. Although complications are infrequent, there are important medical, psychosocial, and financial impacts associated with ICD replacement.

KW - Arrhythmia

KW - Congenital heart disease

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KW - Pediatrics

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