Cosmetic outcomes and quality of life in children with cardiac implantable electronic devices

Katja M. Gist*, Bradley S. Marino, Claire Palmer, Frank A. Fish, Jeremy P. Moore, Richard J. Czosek, Amy Cassedy, Martin J. LaPage, Ian H. Law, Jason Garnreiter, Bryan C. Cannon, Kathryn K. Collins

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Axillary implant location is an alternative implant location in patients for cardiac implantable electronic devices (CIEDs) for the purposes of improved cosmetic outcome. The impact from the patient's perspective is unknown. The purpose of this study was to compare scar perception scores and quality of life (QOL) in pediatric patients with axillary CIED implant location versus the standard infraclavicular approach. Methods: This is a multicenter prospective study conducted at eight pediatric centers and it includes patients aged from 8 to 18 years with a CIED. Patients with prior sternotomy were excluded. Scar perception and QOL outcomes were compared between the infraclavicular and axillary implant locations. Results: A total of 141 patients (83 implantable cardioverter defibrillator [ICD]/58 pacemakers) were included, 55 with an axillary device and 86 with an infraclavicular device. Patients with an ICD in the axillary position had better perception of scar appearance and consciousness. Patients in the axillary group reported, on average, a total Pediatric QOL Inventory score that was 6 (1, 11) units higher than the infraclavicular group, after adjusting for sex and race (P = 0.02). Conclusions: QOL is significantly improved in axillary in comparison to the infraclavicular CIED position, regardless of device type. Scar perception is improved in patients with ICD in the axillary position.

Original languageEnglish (US)
Pages (from-to)46-57
Number of pages12
JournalPACE - Pacing and Clinical Electrophysiology
Issue number1
StatePublished - Jan 2019


  • defibrillation
  • implantable cardioverter defibrillator
  • pacemaker
  • pediatrics
  • quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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