Ventricular pacing in children
Insights
Pediatric cardiac pacing in children showed high complication rates, with many requiring repeat procedures and lead failures. Current indications include congenital and postoperative heart block, and sinus node disease.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Ventricular pacing is a critical intervention for pediatric heart conditions.
- Children present unique challenges for cardiac device implantation and management.
Purpose of the Study:
- To evaluate the outcomes and complications of ventricular pacing in a pediatric population.
- To review current indications and potential technological advancements for pediatric pacing.
Main Methods:
- Retrospective analysis of 41 children (1 day to 20 years) undergoing ventricular pacing.
- Assessment of indications, operative procedures, lead performance, and patient outcomes.
Main Results:
- High rates of pacemaker-related complications were observed, including 66% requiring multiple procedures and 43% experiencing early lead failure.
- No deaths were directly attributed to pacemaker management, despite significant complications.
Conclusions:
- Ventricular pacing in children is associated with substantial procedural and lead-related complications.
- Current indications include symptomatic congenital AV block, sinus node disease, and postoperative heart block.
- Technological and electrophysiologic advancements are needed to improve outcomes in pediatric pacing.
Abstract:
Ventricular pacing was performed in forty-one children ranging from one day to twenty years of age (median age = 10). Weight of the recipient at implant ranged from 2 kg. to 86 kg. Indications included presyncope, syncope, dyspnea on exertion, congestive heart failure, postoperative infra-Hisian heart block, and inadequate cardiac rate during pharmacotherapy. Four patients died during follow-up, but no deaths were attributable to pacemaker management. In contrast, 66% of the patients required more than one pacemaker related-operative procedure, and 43% of leads implanted failed by 48 hours. Indications for permanent cardiac pacing in this population at this time are symptomatic congenital AV block, symptomatic sinus node disease, and AV block in the postoperative period. Technological developments which might reduce complications seen in this population and electrophysiologic techniques which may better define indications for pacing in children are also reviewed.
Related Concept Videos
Electrophysiology of Normal Cardiac Rhythm
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Dysrhythmias III: Characteristics of Dysrhythmias
Dysrhythmias IV: Characteristics of Bradyarrhythmias
Dysrhythmias VI: Management of Dysrhythmias
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias


