Permanent epicardial pacing in pediatric patients : Seventeen years of experience and 1200 outpatient visits

The purpose of this study was to evaluate the long-term outcome of all pediatric epicardial pacing leads. All epicardial leads and 1239 outpatient visits between January 1, 1983, and June 30, 2000, were retrospectively reviewed. Pacing and sensing thresholds were reviewed at implant, at 1 month, and...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2001-05, Vol.103 (21), p.2585-2590
Main Authors: COHEN, Mitchell I, BUSH, David M, VETTER, Victoria L, TANEL, Ronn E, WIEAND, Tammy S, GAYNOR, J. William, RHODES, Larry A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Child
Child, Preschool
Diseases of the cardiovascular system
Follow-Up Studies
Heart - physiopathology
Humans
Infant
Infant, Newborn
Medical sciences
Pacemaker, Artificial
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Survival Rate
Treatment Outcome
Vascular Diseases - mortality
Vascular Diseases - therapy
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Summary:The purpose of this study was to evaluate the long-term outcome of all pediatric epicardial pacing leads. All epicardial leads and 1239 outpatient visits between January 1, 1983, and June 30, 2000, were retrospectively reviewed. Pacing and sensing thresholds were reviewed at implant, at 1 month, and at subsequent 6-month intervals. Lead failure was defined as the need for replacement or abandonment due to pacing or sensing problems, lead fracture, or phrenic/muscle stimulation. A total of 123 patients underwent 207 epicardial lead (60 atrial/147 ventricular, 40% steroid) implantations (median age at implant was 4.1 years [range 1 day to 21 years]). Congenital heart disease was present in 103 (84%) of the patients. Epicardial leads were followed for 29 months (range 1 to 207 months). The 1-, 2-, and 5-year lead survival was 96%, 90%, and 74%, respectively. Compared with conventional epicardial leads, both atrial and ventricular steroid leads had better stimulation thresholds 1 month after implantation; however, only ventricular steroid leads had improved chronic pacing thresholds (at 2 years: for steroid leads, 1.9 muJ [from 0.26 to 16 mu]; for nonsteroid leads, 4.7 muJ [from 0.6 to 25 muJ]; P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.103.21.2585