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Pacemaker therapy in children with complete heart block.

R E Stanton, G G Lindesmith, B W Meyer

    American Journal of Diseases of Children (1960)
    |April 1, 1975
    PubMed
    Summary
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    Permanent pacemaker therapy using P-wave synchronous epicardial pacemakers is effective for children with complete heart block. This study shows long-term efficacy with manageable pulse generator replacements for pediatric complete heart block management.

    Area of Science:

    • Pediatric Cardiology
    • Cardiac Electrophysiology
    • Biomedical Engineering

    Background:

    • Complete heart block in children necessitates permanent pacemaker implantation.
    • P-wave synchronous epicardial pacemakers offer a potential therapeutic solution.
    • Indications include postsurgical heart block, heart failure, syncope, and arrhythmias.

    Purpose of the Study:

    • To evaluate the long-term efficacy and safety of implanted P-wave synchronous epicardial pacemakers in pediatric patients with complete heart block.
    • To assess the need for pulse generator replacements and identify associated complications.

    Main Methods:

    • Ten pediatric patients (8 months to 15 years) with complete heart block received P-wave synchronous epicardial pacemakers.
    • Patients were followed for 38 to 108 months post-implantation.

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  • Data collected included indications for pacing, pulse generator replacements, and adverse events.

    • Main Results:

    • Two deaths occurred, unrelated to pacemaker malfunction.
    • Eight children were followed long-term with 27 pulse generator replacements (23 for battery, 3 for electromechanical failure, 1 for arrhythmia).
    • Eight instances of rhythm disturbances were noted; no infections occurred.

    Conclusions:

    • Implanted P-wave synchronous pacemakers are an effective therapy for children with complete heart block.
    • The procedure demonstrates a favorable long-term safety profile with manageable device-related issues.
    • This pacing modality provides a reliable solution for pediatric complete heart block when indicated.