Pacemaker therapy in children with complete heart block

Insights

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.
  • 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.

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