Related Experiment Videos
Problems with permanent atrial pacing in the Fontan patient
C L Case1, P C Gillette, V Zeigler
1South Carolina Children's Heart Center, Medical University of South Carolina, Charleston.
Pacing and Clinical Electrophysiology : PACE
|January 1, 1989
Summary
Atrial pacing effectively manages arrhythmias in pediatric patients post-Fontan procedure, though challenges remain. Fontan patients require more interventions and medications compared to Transposition of the Great Arteries patients.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Medical Device Technology
Background:
- Transvenous atrial pacing is standard for brady-tachyarrhythmias in pediatric patients with normal atrioventricular conduction.
- The Fontan procedure presents unique challenges for managing arrhythmias in pediatric patients.
Purpose of the Study:
- To review the use of permanent atrial pacing in Fontan patients.
- To compare atrial pacing outcomes in Fontan patients versus post-operative Transposition of the Great Arteries (TGA) patients.
Main Methods:
- Retrospective review of six Fontan patients requiring atrial pacing.
- Comparison of pacing data with a cohort of post-TGA patients.
Main Results:
- Six of 25 Fontan patients (24%) experienced atrial arrhythmias requiring pacing.
- Fontan patients showed higher incidences of symptomatic arrhythmias, hospitalizations, and medication needs post-pacing compared to TGA patients.
- Higher implantation thresholds and less reliable antitachycardia pacing were observed in Fontan patients.
Conclusions:
- Atrial pacing is attainable in Fontan patients but presents greater challenges than in TGA patients.
- The Fontan procedure introduces specific obstacles to successful pediatric atrial pacing.
- Fontan patients may require more intensive management for pacing-related arrhythmia control.