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Permanent cardiac pacemaker implant in the fetal lamb
D Scagliotti1, D D Shimokochi, K C Pringle
1Department of Pediatrics, University of Illinois College of Medicine, Chicago 60612.
Pacing and Clinical Electrophysiology : PACE
|November 1, 1987
Summary
This study demonstrates the feasibility of permanent cardiac pacemaker implantation in fetal lambs. This pioneering research paves the way for potential treatments for fetal heart conditions like bradyarrhythmias.
Area of Science:
- Cardiovascular Research
- Fetal Surgery
- Biomedical Engineering
Background:
- Fetal bradyarrhythmias can lead to congestive heart failure.
- Current treatments for fetal heart conditions are limited.
- Permanent cardiac pacing in utero has not been established.
Purpose of the Study:
- To assess the feasibility of permanent cardiac pacemaker implantation in fetal lambs.
- To evaluate the safety and efficacy of the procedure in a preclinical model.
Main Methods:
- Five fetal lambs (100-115 days gestation) underwent left thoracotomy and epicardial lead implantation on the left ventricle.
- An implantable pulse generator was connected and programmed to ventricular inhibited (VVI) mode.
- Pacing parameters were monitored electrocardiographically, and lambs were assessed at term or post-mortem.
Main Results:
- One lamb survived to term with successful pacing, showing minimal changes in lead function over time.
- Four lambs died in utero between 5 and 26 days post-implantation.
- Pacing parameters remained within safe limits for the surviving lamb.
Conclusions:
- Permanent cardiac pacemaker implantation is feasible in fetal lambs.
- The procedure shows promise for treating fetal congestive heart failure due to bradyarrhythmias.
- Further development is needed for potential human application.