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Implantation of Total Artificial Heart in Congenital Heart Disease
07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

[Complete heart block and pacemaker therapy in children (author's transl)]

J Stoermer, G Schramm

    Monatsschrift Fur Kinderheilkunde
    |December 1, 1979
    PubMed

    Insights

    Congenital heart block generally has a better prognosis than acquired heart block. Immediate pacemaker implantation is crucial for acquired heart block in children experiencing significant heart rate decline or Adams-Stokes attacks.

    Area of Science:

    • Cardiology
    • Pediatric Electrophysiology
    • Congenital Heart Disease

    Context:

    • Congenital and acquired complete heart block present distinct etiologies and prognoses.
    • Suprabifurcational blocks, often congenital, differ significantly from infrabifurcational blocks, typically acquired.
    • Understanding these differences is crucial for appropriate clinical management.

    Purpose:

    • To differentiate between congenital and acquired complete heart block.
    • To outline the distinct clinical characteristics and prognoses of suprabifurcational versus infrabifurcational blocks.
    • To provide guidance on pacemaker selection and implantation timing in pediatric patients.

    Summary:

    • Congenital suprabifurcational blocks feature normal QRS, higher heart rates, and exercise adaptation, generally requiring pacemakers later in life.
    • Acquired infrabifurcational blocks present with widened QRS, fixed low heart rates (40-50 bpm), and necessitate immediate pacemaker implantation if heart rate drops below 30-40 bpm or Adams-Stokes attacks occur.
    • Demand pacemakers are recommended over obsolete fixed-rate systems, with lithium batteries preferred for longevity and size.

    Impact:

    • Improved management strategies for pediatric complete heart block based on etiology and block type.
    • Enhanced decision-making regarding pacemaker implantation timing and device selection.
    • Highlights ongoing challenges in pacemaker surgery, including infection and hardware complications, necessitating further research and technical solutions.

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