{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:03:47Z","timestamp":1791295427505,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The subcutaneous implantable cardioverter\u2010defibrillator (S\u2010ICD) avoids transvenous leads and is a promising option for sudden cardiac death (SCD) prevention in pediatric patients. However, mid\u2010term outcomes and post\u2010shock management strategies remain insufficiently characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter, retrospective observational study included pediatric patients (\u2264\u200918\u2009years) who underwent S\u2010ICD implantation between February 2016 and July 2021. Clinical characteristics, pre\u2010implant screening, procedural details, device\u2010related events, and follow\u2010up data were analyzed. The incidence and management of appropriate and inappropriate therapies and subsequent recurrence were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety\u2010six patients (median age 14.5\u2009years) were enrolled and followed for a median of 70\u2009months (29\u201375.0\u2009months). Sensing vector suitability remained stable despite somatic growth. Appropriate shocks occurred in 32 patients (33.7%), while inappropriate shocks occurred in 27 (28.4%). After appropriate therapy, intensified pharmacological treatment and catheter ablation prevented recurrent device therapy in 45.5% and 50.0% of cases, respectively, although device shock occurred in 50.9% despite intervention. Following inappropriate therapy, device reprogramming and lifestyle guidance prevented recurrence in 71.4% of patients (15\/21). Device\u2010related infection was rare (2 cases), and no lead fractures were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>S\u2010ICD therapy demonstrated favorable mid\u2010term safety and efficacy in pediatric patients, with durable sensing performance and a low incidence of device\u2010related infection. Although inappropriate shocks were not uncommon, appropriate post\u2010shock management effectively reduced recurrence, supporting S\u2010ICD as a viable option for selected pediatric patients without pacing requirements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70420","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:05:54Z","timestamp":1784005554000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Midterm Efficacy of\n                    <scp>SubcutAneous<\/scp>\n                    Implantable\n                    <scp>CardioVErter<\/scp>\n                    \u2010Defibrillator in \u2264\u200918\u2009Year\u2010Old\n                    <scp>CHILDREN<\/scp>\n                    (\n                    <scp>SAVE CHILDREN<\/scp>\n                    \u2010\n                    <scp>II<\/scp>\n                    Registry)"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1172-2995","authenticated-orcid":false,"given":"Hitoshi","family":"Mori","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology Saitama Medical University International Medical Center  Saitama Japan"},{"name":"Department of Cardiology Saitama Medical University International Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1642-6968","authenticated-orcid":false,"given":"Taisuke","family":"Nabeshima","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Saitama Medical University International Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Nagaoka","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Saitama Medical University International Medical Center  Saitama 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