Related Experiment Videos
Risks and benefits of cardiac pacing in children
Insights
Permanent pacemaker implantation is a reliable treatment for pediatric bradyarrhythmia, improving quality of life and life expectancy. While complications can necessitate reoperation, the overall outcomes for children with cardiac rhythm disorders are positive.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Biomedical Engineering
Background:
- Pediatric bradyarrhythmia, often postsurgical, congenital, or acquired, poses significant risks to children's quality of life and life expectancy.
- Permanent pacemaker systems are crucial for managing these rhythm disorders in pediatric populations.
- Epicardial electrodes are commonly used in pediatric pacemaker implantation.
Purpose of the Study:
- To evaluate the efficacy and safety of permanent pacemaker systems in pediatric patients.
- To analyze the indications, complications, and long-term outcomes of pacemaker implantation in children.
- To assess the impact of artificial cardiac stimulation on the quality of life and survival rates in pediatric patients with rhythm disorders.
Main Methods:
- Retrospective analysis of 49 pediatric patients (2 days to 14 years) who underwent permanent pacemaker system implantation.
- Review of patient records to identify indications for pacemaker implantation, focusing on surgically induced bradyarrhythmia.
- Analysis of follow-up data, including reoperation rates, causes of complications (e.g., epicardial electrode issues), mortality, and pacemaker function.
Main Results:
- Eighty-four percent of the 49 patients required pacemaker implantation due to surgically induced bradyarrhythmia.
- Over a follow-up period of 2 to 140 months, 16 reoperations were necessary in 12 children, primarily due to epicardial electrode complications (9 threshold rise, 2 lead fracture, 1 dysfunction).
- Four patients died during the follow-up period, with intact pacemaker function noted in all cases.
Conclusions:
- Permanent pacemaker systems are a reliable method for improving the quality of life and life expectancy in children with postsurgical, congenital, and acquired rhythm disorders.
- While complications related to epicardial electrodes can occur, necessitating reoperation, artificial cardiac stimulation remains a vital therapeutic option.
- The study underscores the long-term benefits and reliability of pacemaker therapy in managing pediatric cardiac rhythm abnormalities.
Abstract:
Forty-nine patients aged 2 days to 14 years (30% below 1 year of age) required implantation of a permanent pacemaker system. Surgically induced bradyarrhythmia was the main indication for treatment (84% of patients). In the follow-up period (ranging from 2 to 140 months) 16 reoperations became necessary for complications in 12 children. Twelve of these were caused by problems related to function of the epicardial electrode (threshold rise 9, lead fracture 2, dysfunction 1). Four patients died, but pacemaker function had remained intact in all. Our experience confirms that artificial cardiac stimulation has become a reliable instrument for improving quality of life and life expectancy of children endangered by postsurgical, congenital and acquired rhythm disorders.