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[Indications and results of artificial pacemaker implantation in children]
Insights
This study analyzed 74 children undergoing pacemaker implantation for heart rhythm issues. Most cases involved iatrogenic atrioventricular blockades, with successful outcomes in most patients receiving electrocardiostimulators.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
Background:
- Pacemaker implantation is a critical intervention for pediatric heart rhythm disorders.
- Congenital and acquired conditions can lead to significant arrhythmias in children.
Purpose of the Study:
- To evaluate the outcomes of pacemaker implantation in a pediatric population.
- To identify the primary indications for cardiac pacing in children.
- To assess the safety and efficacy of different implantation methods.
Main Methods:
- Retrospective analysis of 74 pediatric patients (13 months to 15 years) undergoing 130 operations (56 reoperations) between 1989 and 1999.
- Diagnosis of atrioventricular blockades (iatrogenic, congenital, postmyocarditic).
- Implantation techniques included myocardial electrodes (48 patients) and endocardial methods (26 patients).
- Diagnostic tools: Electrocardiogram (ECG), Holter monitoring, echocardiography with Doppler.
- Postoperative management involved individualized electrocardiostimulator parameter selection guided by echocardiography.
Main Results:
- Iatrogenic atrioventricular blockades were the most common indication (63.5%).
- Congenital and postmyocarditic alterations accounted for 36.5% of cases.
- Primary pacemaker implantation was performed in 48 patients via myocardial electrodes and 26 via endocardial approach.
- Three postoperative deaths occurred due to heart failure, brain edema, and ventricular fibrillation.
- Individualized pacemaker programming was crucial in the postoperative period.
Conclusions:
- Pacemaker implantation is a viable treatment for pediatric heart rhythm abnormalities, particularly iatrogenic atrioventricular blockades.
- Careful patient selection and individualized programming are essential for optimal outcomes.
- Further research into minimizing iatrogenic complications is warranted.
Abstract:
Since 1989 till 1999 operations were performed on 74 children aged from 13 months to 15 years. There were 130 operations, 56 reoperations included. Iatrogenic atrioventricular blockades were diagnosed in 47 children (63.5%), congenital and postmyocarditic alterations in the rhythm and cardiac conductivity--in 27 children (36.5%). In 48 patients the primary implantation of electrocardiostimulators was fulfilled using myocardial electrodes, in 26 cases the endocardial method was used. Three children died at the postoperative period. The causes of death were the growing heart failure, hypoxic brain edema, ventricular fibrilation. ECG, Holter monitoring, echocardiography with dopplerography were made in the children in order to solve the question of the implantation of artificial pace-makers. At the postoperative period the electrocardiostimulators' parameters were selected individually under control of echocardiography.