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Evaluation of pacemaker pulse generator and patient longevity in patients aged 1 day to 20 years
Insights
Pediatric pacemaker longevity was assessed in 96 patients, with patient survival reaching 70% by 109 months. Generator survival was 82% at six months, with failures often linked to patient mortality or device malfunction.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Pacemaker implantation in pediatric patients presents unique challenges due to growth and long-term device management.
- Evaluating device longevity and patient survival is crucial for optimizing care in this population.
Purpose of the Study:
- To assess the long-term survival rates of pediatric patients with pacemakers.
- To evaluate the performance and survival of implanted pulse generators in children and adolescents.
Main Methods:
- Retrospective analysis of 162 pulse generator implantations in 96 pediatric patients (1 day to 20 years) from 1970-1985.
- Categorization of pulse generators into four groups based on technology (asynchronous, mercury-zinc, rechargeable, lithium batteries).
- Analysis of reasons for generator removal and calculation of patient and generator survival rates.
Main Results:
- Patient survival was 84% at 6 months and 70% by 109 months, with no further decline.
- Six-month generator survival was 82%, primarily influenced by patient deaths.
- Top reasons for generator removal included device failure (54%) and patient mortality (24%).
Conclusions:
- Pediatric pacemaker patients demonstrate significant long-term survival.
- Pulse generator survival is influenced by patient outcomes and device technology.
- Further research into advanced pacemaker technologies is warranted for improved pediatric patient management.
Abstract:
The longevity of pediatric patients requiring pacemakers and the survival rates of the implanted generators were evaluated. From January 1970 to December 1985, 96 patients aged 1 day to 20 years underwent 162 pulse generator implantation procedures. Indication for initial implantation was surgically induced heart block in 52 patients, sick sinus syndrome in 20, congenital complete heart block with symptoms of low cardiac output in 19 and tachydysrhythmia control in 5. Modal age at initial implantation was less than 1 year; median age was 5 years. During this period 90 generators were removed from service: 49 (54%) because of generator failure, 22 (24%) because the patient died, 12 (13%) because of elective upgrade at the time of lead failure or cardiac surgery, 5 (6%) because of generator pocket infection and 2 (2%) because of manufacturer's recall. Pulse generators were separated into 4 groups based upon generator technology. Group I (n = 16) were asynchronous units with mercury-zinc batteries; group II (n = 18) were single-chamber demand units with mercury-zinc batteries; group III (n = 14) were single-chamber demand units with rechargeable batteries; and group IV (n = 114) were single- or dual-chamber demand units with lithium batteries. Patient survival rate was 84% at 6 months and 70% by 109 months. There was no further decrease to the end of the study period. Six-month generator survival rate was 82% for all groups, mostly a reflection of patient deaths.(ABSTRACT TRUNCATED AT 250 WORDS)