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Published on: July 18, 2014
Pediatric endocardial temporary pacemaker implantation: Clinical characteristics and outcomes from a Chinese National
Zhongyuan Liu1, Kaijun Zhang1, Jun Ren1
1Department of Cardiology Children's Hospital of Chongqing Medical University National Clinical Research Center for Child Health and Disorders Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Key Cardiovascular Specialty Chongqing China.
Insights
Endocardial temporary pacemakers (TP) show promise in treating pediatric heart conditions, especially fulminant myocarditis (FM). Many children successfully recover sinus rhythm and have the TP removed, though some require permanent pacemakers.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Devices
- Critical Care Medicine
Background:
- Endocardial temporary pacemakers (TP) are established in adult cardiovascular care.
- Limited pediatric data exists for endocardial TP application and clinical outcomes.
- Pediatric cardiovascular diseases necessitate effective temporary pacing solutions.
Purpose of the Study:
- To evaluate the clinical experience and efficacy of endocardial temporary pacemakers (TP) in a pediatric setting.
- To analyze outcomes of pediatric patients receiving endocardial TP implantation.
- To assess the role of endocardial TP in treating critical pediatric heart conditions, including fulminant myocarditis.
Main Methods:
- Retrospective analysis of pediatric patients who received their first endocardial TP implantation.
- Data collected from 2016 to 2022 at a major Chinese pediatric medical center.
- Inclusion criteria: first-time endocardial TP implantation in pediatric cardiology patients.
Main Results:
- 45 pediatric patients underwent endocardial TP implantation.
- 55.56% of patients converted to sinus rhythm and had TP removed; 28.89% required permanent pacemakers.
- In fulminant myocarditis (FM) cases, 80% converted to sinus rhythm and had TP removed; 15% required permanent pacemakers.
Conclusions:
- Endocardial temporary pacemakers (TP) demonstrate significant efficacy in pediatric cardiovascular treatment.
- TP are particularly effective for critical conditions like fulminant myocarditis (FM) in children.
- Successful TP use can lead to recovery of sinus rhythm and device removal in a majority of pediatric patients.
Abstract:
Endocardial temporary pacemakers (TP) are widely used in the treatment of cardiovascular diseases in adults, but their application and clinical experience in the treatment of pediatric cardiovascular cases are relatively limited. This study aims to share the experience of using endocardial TP at a pediatric medical center in China. The study included patients who received their first endocardial TP implantation in the Department of Cardiology at Children's Hospital of Chongqing Medical University, China, from 2016 to 2022. A retrospective analysis of their clinical data was conducted. Our study involved 45 children who underwent endocardial TP implantation. Among these, 25 children (55.56%) converted to sinus rhythm after pacemaker parameter adjustment and the pacemaker was successfully removed; 13 children (28.89%) did not recover sinus rhythm and ultimately required a permanent pacemaker; in 4 cases, the family refused permanent pacemaker implantation; in 1 case, the treatment was abandoned by the family; and 2 children died during hospitalization. Notably, among the 20 children with fulminant myocarditis (FM), 16 children (80.00%) converted to sinus rhythm after pacemaker parameter adjustment and the pacemaker was successfully removed; 3 children (15.00%) ultimately received a permanent pacemaker; and 1 child died during hospitalization. Endocardial TP have shown remarkable efficacy in the treatment of critical heart disease, especially FM.
