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Cardiac pacing in neonates, infants, and preschool children

P C Gillette1, V L Zeigler, A T Winslow

  • 1South Carolina Children's Heart Center, Medical University of South Carolina, Charleston 29425.

Insights

Pediatric pacemaker patients under 5 years old showed good long-term device function. Most children maintained their original pacing mode, with few requiring reoperation for battery or lead issues.

Area of Science:

  • Pediatric Cardiology
  • Biomedical Engineering
  • Implantable Electronic Devices

Background:

  • Pacemakers are crucial for managing pediatric heart rhythm disorders.
  • Long-term outcomes of pacemakers in young children require ongoing evaluation.
  • Understanding device longevity and potential complications is essential for patient management.

Purpose of the Study:

  • To assess the long-term performance and safety of pacemakers in children under five years old.
  • To evaluate the need for reoperations and identify common causes.
  • To determine the durability of pacing modes in this pediatric population.

Main Methods:

  • A retrospective follow-up study of 37 children implanted with pacemakers before age five.
  • Patient data collected over a follow-up period ranging from 1 to 105 months.
  • Analysis of reoperation rates, reasons for reoperation, and pacing mode stability.

Main Results:

  • Five out of 37 patients (13.5%) needed reoperation due to battery depletion.
  • Two patients (5.4%) required reoperation for exit block in epicardial ventricular leads.
  • All patients initially paced in DDD or AAI mode remained in their original pacing mode throughout the follow-up period.

Conclusions:

  • Pacemakers demonstrate reliable long-term function in children under five.
  • Battery depletion and lead issues represent the primary reasons for reoperation in this cohort.
  • The DDD and AAI pacing modes are stable and effective for long-term use in young pediatric patients.

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