Related Experiment Video
Updated: Jun 15, 2026
Translational Rabbit Model of Chronic Cardiac Pacing
Published on: January 6, 2023
Long-term follow-up after steroid-eluting epicardial pacemaker implantation in young children: a single centre
Nestoras Papadopoulos1, Amin Rouhollapour, Peter Kleine
1Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Hospital, Theodor-Stern-Kai 7, 60596 Frankfurt/Main, Germany. nestoras.papadopoulos@gmail.com
Insights
Epicardial pacemaker implantation in young children demonstrated satisfactory outcomes, with lead fracture being the primary reason for reoperation. Reoperations were low-risk, indicating a safe procedure for pediatric patients requiring pacing.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Cardiac Electrophysiology
Background:
- Epicardial pacing is a crucial intervention for pediatric patients with atrioventricular block when transvenous leads are not feasible.
- Long-term outcomes and failure modes of epicardial pacing in young children require thorough investigation.
Purpose of the Study:
- To retrospectively analyze the clinical outcomes of epicardial pacemaker implantation in young children.
- To identify modes of failure leading to reoperation and report long-term results.
Main Methods:
- Retrospective analysis of 45 young children (mean age 3.2 years) who underwent epicardial pacemaker implantation between 2000 and 2008.
- Follow-up duration of 5.7 years to assess lead performance, pacing thresholds, and reoperation rates.
- Evaluation of congenital and post-operative atrioventricular block etiologies.
Main Results:
- Five lead malfunction events (11%) occurred, with three cases of ventricular lead fracture.
- Actuarial freedom from reoperation at 6 years was 88.8%.
- Stable and excellent long-term ventricular and atrial pacing thresholds were observed post-revision.
Conclusions:
- Epicardial pacing in this cohort of young children yielded satisfactory clinical outcomes and acceptable long-term results.
- Lead fracture was the predominant cause for reoperation, which was performed with low risk.
- Epicardial pacing remains a viable option for pediatric patients with specific pacing needs.
Aims:
The purpose of this paper is the retrospective investigation of the clinical outcome and modes of failure leading to reoperation, as well as the report of the long-term results, in a group of young children who underwent epicardial pacemaker implantation.
Methods And Results:
Between 2000 and 2008, 45 young children underwent epicardial pacemaker implantation at 3.2 +/- 2.5 years of age for congenital (n = 27) or post-operative (n = 18) atrioventricular block. The follow-up time was 5.7 years +/- 5 months (range: 6 months to 7.3 years). Five lead malfunction events (11%) were detected during the follow-up time, three of which were due to ventricular lead fracture. All revisions could be performed without complications, and all revised pacemakers showed stable pacing and sensing parameters during long-term follow-up. The actuarial freedom from reoperation at 6 years was 88.8 +/- 2%. Median epicardial ventricular and atrial pacing thresholds were stable and excellent at the latest follow-up, with means of 1.1 +/- 0.5 V and 0.7 +/- 0.8 V, respectively.
Conclusion:
In our patient cohort of 45 young children, epicardial pacing was associated with a satisfactory clinical outcome and acceptable long-term results. The major cause of reoperation in our series was lead fracture. Reoperations were performed at a low risk.
