Permanent cardiac pacemaker in infants and children

Area of Science:

• Pediatric Cardiology
• Biomedical Engineering
• Cardiac Electrophysiology

Background:

• Congenital and surgically acquired heart conditions can lead to significant bradycardia and sinus node dysfunction in infants and children.
• Effective management of these rhythm disturbances is crucial for improving quality of life and long-term outcomes in pediatric patients.
• Permanent cardiac pacing has become a vital therapeutic option for managing complex heart rhythm disorders in young individuals.

Purpose of the Study:

• To evaluate the safety and efficacy of permanent cardiac pacemaker implantation in a cohort of infants and children.
• To assess the long-term outcomes and complication rates associated with cardiac pacing in a pediatric population.
• To determine the impact of modern pacemaker systems on symptomatic relief and overall well-being in young patients with heart rhythm abnormalities.

Main Methods:

• Retrospective analysis of 26 pediatric patients (aged 11 days to 18 years) who received 42 permanent cardiac pacemakers between October 1970 and November 1984.
• Detailed review of pacemaker types (unipolar, bipolar, fixed-rate, demand, VAT, DDD), implantation procedures (epicardial, endocardial), and re-implantation surgeries.
• Assessment of 30-day hospital mortality, long-term mortality, re-operation rates, and symptomatic status during follow-up (3 months to 10 years).

Main Results:

• A total of 26 primary pacemaker implantations and 16 re-implantations were performed for various heart rhythm disorders.
• The 30-day hospital mortality rate was 11.5% (3/26), with one death possibly linked to pacing failure.
• Sixteen of the 19 survivors experienced complete symptomatic relief without requiring medical therapy, demonstrating significant functional improvement.

Conclusions:

• Modern cardiac pacemaker systems are demonstrably safe and reliable for use in infants and children.
• Permanent pacemaker implantation leads to substantial and sustained symptomatic relief in the majority of pediatric patients.
• Cardiac pacing represents an effective long-term management strategy for congenital and acquired heart rhythm disorders in the pediatric population.