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Abstract：
In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients.
摘要：
鉴于当前时代心血管可植入电子设备（CIED）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。本文件是一项专家共识声明，旨在更新和进一步描述儿科患者CIED的适应症和管理。定义为≤21岁，并旨在主要关注特定疾病类别中CIED的适应症。该文件还强调了以前发表的成人和儿科CIED建议之间的差异，并为潜在的重要差异提供了理由。该文件讨论了低收入和中等收入国家对CIED获取的一些阻碍因素以及规避这些因素的策略。文件部分由写作委员会成员根据他们的专业知识进行划分和起草。这些建议代表了整个写作委员会的共识意见,按推荐类别和证据级别分级。本文件中涉及的几个问题要么不适合临床试验，要么是罕见的疾病实体，在这些情况下，建议是基于一致的专家意见。此外，具体建议,即使有大量数据支持，不要取代临床判断和患者特定决策的需要。这些建议已向儿科及先天性电生理学会(PACES)成员公开征询公众意见,并接受心律学会(HRS)科学及临床文件委员会的外部审查,美国心脏协会（AHA）的科学咨询和协调委员会，美国心脏病学会（ACC），和欧洲儿科和先天性心脏病协会（AEPC）。该文件获得了所有合作者和亚太心律协会（APHRS）的认可，印度心脏节律学会（IHRS），和拉丁美洲心律协会（LAHRS）。该文件有望为临床医生和患者提供支持，以允许适当的CIED使用，适当的CIED管理，并对儿科患者进行适当的CIED随访。
