Case report: Challenges and implications of conduction system pacing in pediatrics: Case series

Area of Science:

• Cardiology
• Pediatric Electrophysiology
• Biomedical Engineering

Background:

• Cardiac electrical stimulation in children is typically required for congenital atrioventricular block, post-surgical heart block, and bradycardia linked to channelopathies.
• Conventional right ventricular pacing in pediatric patients raises concerns about potential long-term adverse effects.
• Conduction system pacing, a physiologic approach, has gained traction in adults and is being explored for pediatric applications.

Observation:

• This study presents three pediatric cases utilizing conduction system pacing techniques.
• The cases involve His bundle pacing and left bundle branch pacing.
• The focus is on the unique characteristics and challenges associated with these advanced pacing methods in children.

Findings:

• Conduction system pacing demonstrates feasibility in pediatric patients.
• These techniques offer a potentially more physiologic alternative to traditional pacing.
• Specific technical considerations and challenges were identified during implantation and follow-up.

Implications:

• Conduction system pacing may mitigate the risks of chronic right ventricular stimulation in children.
• This approach holds promise for improving long-term outcomes in pediatric patients requiring cardiac pacing.
• Further research and experience are needed to fully establish the role of conduction system pacing in pediatric cardiology.