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[MSB-57] Surgically Implanted Cardiac Implantable Electronic Devices (CIED) in Patients Younger Than One Year
Safak Alpat1, Abdüsselam Çorak1, İlker Ertuğrul1
1Department of Cardiovascular Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye.
Insights
Surgically implanted cardiac devices in infants are safe with acceptable mid-term outcomes. Reoperations for pediatric cardiac implantable electronic devices are common and require close monitoring.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Infants often require cardiac implantable electronic devices (CIEDs) due to various heart conditions.
- Surgical implantation is a common method for CIED placement in this age group.
Purpose of the Study:
- To evaluate the safety and outcomes of surgically implanted CIEDs in infants.
- To analyze reoperation rates and reasons in this pediatric population.
Main Methods:
- Retrospective analysis of 38 infants (under one year) who underwent surgical CIED implantation between 2014 and 2024.
- Data collected included patient demographics, indications for CIED, device configurations, follow-up duration, and reoperation details.
Main Results:
- The most common indication was complete atrioventricular block (63%).
- Pacemaker configurations included VVI (81.5%), ICD (8%), CRT (5.25%), and DDD (5.25%).
- 18.4% of patients required reoperations (excluding generator replacements), primarily for lead issues or configuration changes.
Conclusions:
- Surgical implantation of CIEDs in infants is a safe procedure with acceptable mid-term results.
- Reoperations are frequent and necessitate diligent device surveillance for optimal patient management.
Objective:
This study aimed to present our experience with surgically implanted cardiac implantable electronic devices (CIED) in infants.
Methods:
Thirty-eight infants (18 males, 20 females; mean age: 155.6±102.2 days; range, 1 to 343 days) who underwent a surgical procedure to implant CIEDs between 2014 and 2024 were included in the study. Pre-, intra-, and postoperative data were collected and analyzed.
Results:
The mean weight was 5.27±1.99 kg (range, 2.1 to 9 kg). Twenty-four (63%) patients required CIED due to complete atrioventricular block after pediatric heart surgery. In five (13%) patients, the indication was congenital complete atrioventricular block. Remaining 10 (24%) patients had a long QT, congenitally corrected transposition of the great arteries, and cardiomyopathy. Pacemaker configuration was VVI in 31 (81.5%) patients, ICD in three (8%) patients, CRT in two (5.25%), and DDD in two (5.25%). The median follow-up was five years (range, 1 to 10 years). There were no deaths. A total of 12 reoperations were required in seven (18.4%) patients when pacemaker generator replacements were excluded. Five reoperations were related to lead fracture and revision. The remaining seven reoperations were to either upgrade or downgrade pacemaker configurations.
Conclusion:
In patients younger than one year, surgical implantation of CIEDs represents a safe procedure with reasonably acceptable outcomes in the mid-term follow-up. However, reoperations are inevitable, and appropriate reinterventions depend on close device surveillance.
