Related Experiment Videos
Endocardial pacing in infants and children 15 kg or less in weight: medium-term follow-up
1Department of Paediatric Cardiology, Royal Brompton and National Heart Hospital, London, United Kingdom.
Insights
Pediatric pacemaker implantation via transvenous lead placement is generally safe, with most children developing normally. Complications occurred in some, but a novel lead technique showed promise.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Transvenous lead placement is a common method for permanent pacemaker implantation in children.
- Complications associated with pediatric pacemakers can impact patient outcomes and device longevity.
Purpose of the Study:
- To evaluate the safety and efficacy of transvenous permanent pacemaker implantation in children weighing 15 kg or less.
- To assess the complication rates and long-term outcomes in this pediatric population.
Main Methods:
- A retrospective analysis of 24 children (≤15 kg) who underwent transvenous pacemaker implantation.
- Follow-up ranged from 2 months to over 6 years, with detailed recording of complications and reoperations.
Main Results:
- Eight out of 24 children experienced complications, with six requiring reoperation.
- Complications included lead fracture, infection, myocardial dysfunction, generator migration, battery depletion, and threshold rise.
- A redundant ventricular lead loop in the atrium successfully unraveled in all cases.
Conclusions:
- Transvenous pacemaker implantation in small children is feasible, though complication rates necessitate careful monitoring.
- The novel redundant lead technique appears safe and effective for managing lead length in growing children.
- Most children achieve normal growth and development with acceptable cosmetic outcomes post-implantation.
Abstract:
Twenty-four children 15 kg or less in weight (range 2.8-15 kg) underwent implantation of a permanent pacemaker using the transvenous technique of lead placement. During a follow-up period of 2 months to 6 years 1 month (median 3 years 6 months) eight children suffered complications, six of which necessitated reoperation. These included: lead fracture in two, infection in two, transient myocardial dysfunction in one, generator migration in one, premature battery depletion in one, and threshold rise in one. A loop of redundant ventricular lead positioned in the atrium at the time of implant is successfully unravelling in all children. One child died during the follow-up period of a pneumonia unrelated to her pacemaker. The other children are growing and developing normally and the cosmetic appearance has proved acceptable in all cases.