Recent Advancements in Cardiac Implantable Devices for Pediatric Patients

We highlight recent advances in cardiac implantable electronic devices (CIEDs) that are applicable and can be beneficial for pediatric patients.

Progress in pacemakers includes the widespread use of leadless pacemakers, development of tools for left bundle area pacing, and the design of novel miniaturized pacemakers and minimally invasive approaches for epicardial device implantation. For implantable cardioverter defibrillators (ICDs), there has been more utilization of the subcutaneous ICD in smaller patients or those with congenital heart disease, and significant improvements in ICD programming as well.

Leadless pacemakers have been safely utilized in children, even those under 30 kg with acute and medium-term success. Left bundle area pacing may provide a reduction in pacing-induced cardiomyopathy in the future. Novel miniature pacemakers and approaches to epicardial lead implantation can reduce complications for our smallest patients. Subcutaneous ICDs have been used effectively in the pediatric cohort with similar results to the adult population. ICD programming has been improved to reduce the risk of inappropriate shocks.