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VDD-pacemaker in children--a long-term therapy?
M Südkamp1, M Schmid, H-J Geissler
1Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany. michael.suedkamp@uk-koeln.de
The Thoracic and Cardiovascular Surgeon
|June 1, 2005
Summary
Transvenous VDD pacemakers in children are a temporary solution for AV-synchrony. High reoperation rates due to lead tension suggest DDD pacing is better long-term.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Medical Device Technology
Background:
- Transvenous AV-synchronous pacing in pediatric patients utilizes VDD leads and miniaturized pacemakers.
- The long-term efficacy of this therapy in children has been a subject of ongoing investigation.
Purpose of the Study:
- To retrospectively evaluate the long-term outcomes of transvenous VDD pacing in children.
- To assess the safety and complication rates associated with VDD pacemaker implantation in pediatric patients.
Main Methods:
- A retrospective analysis of 104 children under 15 years old who received pacemakers between May 1977 and July 2001.
- Focus on 55 patients with transvenous leads, specifically the 12 who received VDD pacemakers for hemodynamic reasons.
Main Results:
- The mean follow-up period was 47.5 months, with VDD pacing functioning 86.3% of the time.
- Five out of twelve VDD patients (41.7%) required reoperation due to severe lead traction, necessitating explantation and conversion to dual-chamber pacemakers.
Conclusions:
- Perioperative implantation of VDD pacemakers in children is safe with a low initial complication rate.
- Significant lead tension requiring reoperation in 41.7% of VDD patients highlights potential long-term challenges.
- VDD pacing in younger children may serve as a temporary measure, bridging the need for AV-synchrony until conversion to DDD pacing in adulthood is feasible.