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Minimally invasive resynchronization pacemaker: a pediatric animal model.

Christopher P Jordan1, Kyle Wu, John P Costello

  • 1Children's National Medical Center, Washington, DC.

The Annals of Thoracic Surgery
|December 4, 2013
PubMed
Summary
This summary is machine-generated.

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A new minimally invasive technique for epicardial pacemaker implantation was developed and tested in piglets. This method is safe and effective for infants and patients with congenital heart disease when traditional pacing is not an option.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Biomedical Engineering

Background:

  • Transvenous pacemaker implantation is contraindicated in some infants and patients with congenital heart disease.
  • Epicardial pacing offers an alternative but requires effective implantation techniques.
  • Minimally invasive approaches are desirable for pediatric patients.

Purpose of the Study:

  • To develop and evaluate a minimally invasive epicardial pacemaker implantation technique.
  • To establish the feasibility and safety of this method in an infant animal model.
  • To provide a viable pacing solution for complex pediatric cardiac cases.

Main Methods:

  • A subxiphoid needle approach guided by thoracoscopy was used in 5 piglets.
  • Pacing leads were affixed to the left ventricle and left atrial appendage.
Keywords:
24

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  • Pacemaker function was assessed through atrial and ventricular pacing and sensing.

    • Main Results:

    • Successful visualization and fixation of epicardial pacing leads were achieved.
    • Effective atrial and ventricular pacing and sensing were demonstrated.
    • One instance of pneumothorax was managed successfully; no other adverse events were reported.

    Conclusions:

    • Minimally invasive epicardial pacemaker implantation is feasible and effective in an infant model.
    • This technique holds promise for pacing and resynchronization in infants and congenital heart disease patients.
    • Further survival studies are ongoing to evaluate permanent generator implantation.