Permanent pacemaker implantation in infants, children, and adolescents. Long-term follow-up

Area of Science:

• Pediatric Cardiology
• Cardiac Electrophysiology
• Medical Device Technology

Background:

• Complete atrioventricular (A-V) block in children presents significant challenges, often leading to symptoms like cerebrovascular insufficiency and congestive heart failure.
• The etiology of pediatric A-V block varies, including surgical, congenital, and acquired causes, necessitating diverse treatment approaches.

Purpose of the Study:

• To evaluate the long-term efficacy and outcomes of cardiac pacemaker implantation in pediatric patients with complete A-V block.
• To assess the impact of pacemaker therapy on symptom relief, survival rates, and quality of life in this patient cohort.

Main Methods:

• A retrospective study followed 24 pediatric patients who received cardiac pacemakers for complete A-V block.
• Patient data including etiology of A-V block, presenting symptoms, pacemaker performance, and survival status were analyzed over an average follow-up of five years (range 1-12 years).

Main Results:

• Eighteen of the 24 patients (75%) were alive and well at the end of the study period.
• Pacemaker therapy provided symptomatic relief and prolonged life in 18 children with disabling complete A-V block.
• Six deaths occurred, primarily in patients with complex congenital heart defects or Refsum's disease, with some attributed to persistent A-V block or heart failure despite pacing.

Conclusions:

• Cardiac pacemaker implantation is a valuable therapeutic option for pediatric patients suffering from complete A-V block.
• Pacemaker therapy can significantly improve symptom management and survival rates in children with disabling A-V block, although outcomes may be influenced by underlying cardiac conditions.