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What's new in cardiac pacing in children?
1Children's Heart Centre, University Hospital Motol, Prague, Czech Republic.
Insights
Recent advancements in pediatric cardiac pacing and implantable cardioverter-defibrillator (ICD) therapy focus on optimizing ventricular function and lead placement. Future improvements depend on technical refinements and tailored therapy indications for better outcomes in children.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Biomedical Engineering
Background:
- Pediatric cardiac pacing and implantable cardioverter-defibrillator (ICD) therapy are evolving fields.
- Understanding the impact of pacing on ventricular function is crucial for pediatric patients.
Purpose of the Study:
- To review and prioritize recent data on pediatric cardiac pacing published within the last 18 months.
- To provide insights into current developments and future directions in the field.
Main Methods:
- Literature review of recent publications on pediatric cardiac pacing and ICD therapy.
- Analysis of data focusing on ventricular function, lead survival, and therapeutic indications.
Main Results:
- Pacing site significantly influences left ventricular (LV) function and synchrony in pediatric patients.
- Endocardial leads demonstrate survival superiority over epicardial leads, though technical refinements may improve long-term epicardial outcomes.
- Recent guideline changes for cardiac resynchronization therapy (CRT) in adults may impact pediatric indications.
- New data shed light on ICD lead survival and the use of ICDs in young patients with hypertrophic cardiomyopathy.
Conclusions:
- Pediatric cardiac pacing and ICD therapy are advancing with technical improvements, optimized lead placement, and refined indications.
- Continued research and development are expected to enhance treatment efficacy and patient outcomes.
Purpose Of Review:
To review and prioritize data on pediatric cardiac pacing published during the period of the last 18 months.
Recent Findings:
New approaches to preservation of ventricular function in pediatric pacing are based on recent publications confirming major influence of the ventricular pacing site on left ventricular (LV) function and synchrony. Current studies on epicardial vs. transvenous pacing continue to show survival superiority of endocardial leads. Long-term outcome of epicardial pacing may, however, be positively influenced by technical refinements. Recent amendments of the guidelines for cardiac resynchronization therapy (CRT) in adult idiopathic and ischemic cardiomyopathy are likely to influence CRT indications in children. Novel data give interesting insights into implantable cardioverter-defibrillator (ICD) lead survival as well as the use of ICDs in young patients with hypertrophic cardiomyopathy.
Summary:
Pediatric cardiac pacing and ICD therapy is still a developing field likely to improve with technical refinements, proper lead placement and more specific therapy indications. The current review will give the reader information about recent developments and directions for the future.
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