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Abstract：
Guidelines for the implantation of cardiac implantable electronic devices (CIEDs) have evolved since publication of the initial ACC/AHA pacemaker guidelines in 1984 [1]. CIEDs have evolved to include novel forms of cardiac pacing, the development of implantable cardioverter defibrillators (ICDs) and the introduction of devices for long term monitoring of heart rhythm and other physiologic parameters. In view of the increasing complexity of both devices and patients, practice guidelines, by necessity, have become increasingly specific. In 2018, the ACC/AHA/HRS published Guidelines on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay [2], which were specific recommendations for patients >18 years of age. This age-specific threshold was established in view of the differing indications for CIEDs in young patients as well as size-specific technology factors. Therefore, the following document was developed to update and further delineate indications for the use and management of CIEDs in pediatric patients, defined as ≤21 years of age, with recognition that there is often overlap in the care of patents between 18 and 21 years of age. This document is an abbreviated expert consensus statement (ECS) intended to focus primarily on the indications for CIEDs in the setting of specific disease/diagnostic categories. This document will also provide guidance regarding the management of lead systems and follow-up evaluation for pediatric patients with CIEDs. The recommendations are presented in an abbreviated modular format, with each section including the complete table of recommendations along with a brief synopsis of supportive text and select references to provide some context for the recommendations. This document is not intended to provide an exhaustive discussion of the basis for each of the recommendations, which are further addressed in the comprehensive PACES-CIED document [3], with further data easily accessible in electronic searches or textbooks.
摘要：
自1984年发表最初的ACC/AHA起搏器指南以来，心脏植入式电子设备（CIED）的植入指南已经发展[1]。CIED已经发展到包括新形式的心脏起搏，植入式心律转复除颤器(ICD)的发展以及用于长期监测心律和其他生理参数的装置的引入。鉴于设备和患者的复杂性日益增加，实践指南，根据需要,变得越来越具体。2018年，ACC/AHA/HRS发布了《心动过缓和心脏传导延迟患者评估和管理指南》[2]。这是针对年龄>18岁患者的具体建议。鉴于年轻患者中CIED的不同适应症以及特定尺寸的技术因素，建立了此年龄特定阈值。因此,以下文件是为了更新和进一步描述儿科患者使用和管理CIED的适应症，定义为≤21岁，认识到18至21岁之间的专利护理通常存在重叠。本文件是简短的专家共识声明（ECS），旨在主要关注特定疾病/诊断类别中CIED的适应症。本文件还将为CIED儿科患者提供有关铅系统的管理和随访评估的指导。建议以简化的模块化格式提出，每个部分都包括完整的建议表以及支持文本的简短摘要，并选择参考资料，为建议提供一些背景。本文件无意详尽讨论每一项建议的依据,在全面的PACES-CIED文件[3]中进一步讨论了这些问题，更多的数据可以在电子搜索或教科书中轻松获取。
