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Related Experiment Videos

Ventricular pacing threshold variations in the young.

Massimo Stefano Silvetti1, Antonella De Santis, Nicoletta Grovale

  • 1Pediatric Cardiology Department, Ospedale Bambino Gesù, Roma, Italy. silvetti@opbg.net

Pacing and Clinical Electrophysiology : PACE
|March 7, 2007
PubMed
Summary
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Pediatric patients exhibit stable ventricular pacing thresholds, with epicardial leads showing comparable stability to endocardial leads. Ventricular Capture Management (VCM) in pacemakers functions reliably in this population.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Pediatric Electrophysiology

Background:

  • Ventricular Capture Management (VCM) is a pacemaker feature for automatic pacing threshold measurement.
  • Pediatric pacemaker patients present unique challenges regarding lead placement and threshold stability.

Purpose of the Study:

  • To evaluate the variability of ventricular pacing thresholds in pediatric patients with endocardial and epicardial leads.
  • To assess the efficacy and success rate of VCM in a pediatric population.

Main Methods:

  • Retrospective analysis of 31 pediatric patients implanted with Medtronic Kappa pacemakers.
  • VCM programmed to measure thresholds automatically every 2 hours over a median follow-up of 12 months.
  • Comparison of VCM measurement success rates between endocardial and epicardial leads, considering factors like age and congenital heart defects (CHD).

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Main Results:

  • VCM successfully measured thresholds in 94% of patients, with a high success rate (99%) for endocardial leads versus 31% for epicardial leads.
  • Epicardial pacing and CHD were associated with more stable pacing thresholds.
  • Circadian variations in pacing thresholds were observed but were minimal and did not appear to affect VCM function.

Conclusions:

  • Children and young patients demonstrate stable ventricular pacing thresholds, particularly those with CHD.
  • Epicardial leads are as stable as endocardial leads in pediatric patients.
  • VCM is a reliable feature for monitoring ventricular pacing thresholds in pediatric populations, despite minor circadian variations.