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Related Concept Videos

Pulse rhythm01:30

Pulse rhythm

861
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
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Cardiac Catheterization III: Left Heart Catheterization01:24

Cardiac Catheterization III: Left Heart Catheterization

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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Late Extraction of Micra AV and Implantation of Right Atrial Leadless Pacemaker.

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Transcatheter Leadless Pacing in Children: A PACES Collaborative Study in the Real-World Setting.

Maully J Shah1, Alejandro A Borquez2, Daniel Cortez3,4

  • 1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia (M.J.S., C.M.J., V.R.I.).

Circulation. Arrhythmia and Electrophysiology
|April 11, 2023
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Summary

Transcatheter Leadless Pacemakers (TLP) show high success rates in pediatric patients, including those with congenital heart disease. This study found stable electrical performance and few major complications, though long-term data are needed.

Keywords:
CIED infectioncongenital heart diseaseepicardial leadslead failureleadless pacemakerpediatricstransvenous leads

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Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Transcatheter Leadless Pacemakers (TLP) offer a less invasive alternative for adult pacing.
  • Pediatric patients and those with congenital heart disease may benefit from TLP, avoiding repeated surgeries.
  • Clinical trial data for TLP in children are limited, creating uncertainty regarding their use.

Purpose of the Study:

  • To assess the clinical indications for TLP implantation in pediatric patients.
  • To evaluate the procedural characteristics and electrical performance of TLP in children.
  • To determine the safety and outcomes of TLP in the pediatric population.

Main Methods:

  • Retrospective analysis of data from the Pediatric and Congenital Electrophysiology Society TLP registry.
  • Inclusion of patients ≤21 years old who underwent Micra TLP implantation with ≥1 week follow-up.
  • Data collected from 15 participating centers.

Main Results:

  • Successful TLP implantation in 98% of 63 pediatric patients (mean age 15 years).
  • 20% of patients had congenital heart disease; 8 patients were ≤8 years old and ≤30 kg.
  • High implantation success via femoral (87%) and internal jugular (12.6%) venous approaches, with stable electrical parameters and infrequent major complications (16%).

Conclusions:

  • TLP implantation via femoral and internal jugular veins is highly successful in pediatric patients.
  • Micra TLP demonstrated stable electrical parameters and a low rate of major complications in this cohort.
  • Further long-term prospective studies are required to validate these initial findings.