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Clinical analysis of temporary pacemaker implantation in 13 children
1Department of Cardiology, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China.
Insights
Temporary pacemakers are safe and effective for pediatric cardiovascular emergencies. This study shows successful outcomes in children with critical heart conditions, including myocarditis and post-surgery arrhythmias.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Critical Care Medicine
Background:
- Temporary pacemaker implantation is common in adults but less studied in children.
- Pediatric research on temporary pacemakers for acute cardiovascular diseases is limited.
- This study addresses the application of temporary pacemakers in critically ill children.
Purpose of the Study:
- To explore the application and efficacy of temporary pacemakers in children with acute and critical cardiovascular diseases.
- To analyze the outcomes of temporary pacemaker implantation in a pediatric cohort.
- To evaluate the safety and effectiveness of temporary pacing in pediatric cardiac emergencies.
Main Methods:
- Retrospective analysis of clinical data from 13 children treated with temporary pacemakers.
- Data collected from Tianjin Children's Hospital between October 2017 and February 2021.
- Included patients with conditions like fulminant myocarditis, complete atrioventricular block, and post-open heart surgery arrhythmias.
Main Results:
- 13 children (4 male, 9 female; mean age 71.2 months) received temporary pacemakers (9 endocardial, 4 epicardial).
- Successful rhythm restoration in 11 children within 5 hours; pacing duration averaged 134 hours.
- Minor complications included poor pacing (2) and catheter displacement (1); long-term follow-up showed normal cardiac function and no new arrhythmias.
Conclusions:
- Temporary pacemakers offer a simple, safe, and effective treatment for acute and critical cardiovascular conditions in children.
- The procedure demonstrated a remarkable effect in managing pediatric cardiac emergencies.
- Positive outcomes and functional recovery were observed in the majority of patients.
Background:
At present, temporary pacemaker implantation is very common in the treatment of cardiovascular diseases in adults. However, the number of pediatric pacemakers implanted is still relatively small, and relevant research is also far less than that of adults. This study aimed to explore the application of temporary pacemakers in children with acute and critical cardiovascular diseases.
Methods:
The clinical data of children with cardiovascular diseases who were treated with temporary pacemakers in Tianjin Children's Hospital from October 2017 to February 2021 were analyzed retrospectively.
Results:
A total of 13 children with cardiovascular diseases were included in this study, including 4 males and 9 females, mean age of 71.2±56.3 months, and median body weight of 15.5 kg. There were 9 children with endocardial pacing and 4 children with epicardial pacing. The types of diseases included fulminant myocarditis (n=8), complete atrioventricular block (CAVB; n=1), and arrhythmias after open heart surgery (n=4). The median time from onset to admission was 1.0 days in children with endocardial pacing and there was cardiac arrest in 2 children, heart failure in 9 children, cardiogenic shock in 8 children, and Adams-Stokes attack in 7 children. The median time from admission to implantation of temporary pacemakers was 3.0 h and the operation time was 55.0±19.4 min. All 4 children with epicardial pacing had pacemakers implanted during operation because of CAVB. The pacing mode was VVI mode. The initial perceptual voltage was 1-2 mv, the output voltage was 5v, and the pacing frequency was 70-145 bpm. A total of 11 children reverted to sinus rhythm within 5.0 (1.8-34.0) h and the working time of temporary pacemakers was 134.0 (15.0-191.0) h. There was poor pacing in 2 children and catheter displacement in 1 child during pacing. A total of 12 children were followed up for 20.0±12.5 months and 1 was lost to follow-up. During the follow-up period, the cardiac functions were basically normal and no new arrhythmia appeared.
Conclusions:
Temporary pacemakers have the advantage of simple operation, definite effect, and safety which has a remarkable effect in the treatment of acute and critical cardiovascular diseases in children.
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