Electrophysiologic Devices in Heart Failure

With the advent of new technology allowing cardiac devices to be smaller in size, the application of both implantable cardioverter defibrillator (ICD) and pacemaker technology in the pediatric patient with heart failure has expanded. The use of ICDs to decrease the incidence of sudden death and cardiac resynchronization therapy pacemakers have now become an important consideration in the treatment of young patients. Devices can also now also be used to quantify a patient's degree of heart failure. Because of the relatively small number of pediatric patients, specific indications are not as well defined as in the adult population. This chapter discusses indications and practical aspects of implantation of pacemakers and ICDs in the pediatric heart failure population.