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Pacemaker treatment of sick sinus syndrome in children
Insights
Permanent cardiac pacing effectively treats sick sinus syndrome in children, relieving symptoms and improving associated tachyarrhythmias. This safe procedure offers significant symptomatic relief for pediatric patients with this cardiac condition.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Cardiac Pacing
Background:
- Sick sinus syndrome is increasingly diagnosed in children.
- While sometimes benign, it can lead to severe or fatal outcomes.
- Permanent cardiac pacing is a treatment option for pediatric sick sinus syndrome.
Purpose of the Study:
- To evaluate the safety and efficacy of permanent cardiac pacing in children with sick sinus syndrome.
- To assess symptom relief and management of associated tachyarrhythmias.
- To report on long-term outcomes and potential complications.
Main Methods:
- A retrospective analysis of 51 pediatric patients with sick sinus syndrome who underwent permanent cardiac pacing.
- Details of pacing types (epicardial ventricular, atrial, AV sequential, universal; endocardial atrial, universal) were recorded.
- Patient demographics, symptoms, tachyarrhythmias, and follow-up data including reoperations and mortality were analyzed.
Main Results:
- 45 out of 49 symptomatic patients experienced relief.
- 11 of 18 patients with tachyarrhythmias showed improvement.
- Two late deaths occurred, unrelated to pacemakers; 7 patients required reoperation for lead/sensing issues over a mean 26-month follow-up.
Conclusions:
- Permanent cardiac pacing is a safe and effective procedure for managing sick sinus syndrome in children.
- The intervention provides significant symptomatic improvement.
- While complications like lead issues can necessitate reoperation, overall outcomes are favorable.
Abstract:
The sick sinus syndrome is being recognized with increasing frequency in children. Although it is sometimes benign, it can be serious or have fatal consequences. Fifty-one patients (mean age 10.5 years) underwent permanent cardiac pacing for sick sinus syndrome. Twenty patients had epicardial ventricular pacing and 12 had an epicardial atrial implant. Seven had endocardial atrial pacing, six epicardial atrioventricular (AV) sequential pacing, four epicardial universal pacing and two endocardial universal pacing. Of the 49 symptomatic patients, 45 had relief of symptoms. Eleven of 18 patients with associated tachyarrhythmias had amelioration of their tachycardia. There were no early but two late deaths unrelated to the pacemakers. Seven patients during a mean follow-up period of 26 months required reoperation for pacing lead or sensing problems. Permanent pacing for sick sinus syndrome in children is a safe and symptomatically effective procedure.