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Cardiac pacemakers in infants and children as observed in The Netherlands
Insights
Pediatric pacemaker implantations showed mixed outcomes. While many children received pacing, complications and device failures led to significant mortality and reoperation rates.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Medical Device Technology
Background:
- Cardiac pacemakers are vital for managing pediatric heart rhythm disorders.
- Long-term data on pediatric pacemaker implantation outcomes is crucial for clinical practice.
Purpose of the Study:
- To analyze the indications and outcomes of cardiac pacemaker implantations in children in The Netherlands.
- To evaluate patient survival and reoperation rates associated with pediatric pacemaker use.
Main Methods:
- Retrospective analysis of all pediatric pacemaker implantations in The Netherlands from 1963 to mid-1979.
- Data collection on patient demographics, indications for pacing, implantation procedures, and follow-up outcomes.
Main Results:
- A total of 76 children (5 infants, 71 older children) received pacemakers, accumulating 184 patient years.
- Seven deaths occurred: two in infants shortly after birth, four due to pacemaker failure in sick sinus syndrome (three post-Mustard operation), and one myocardial infarction.
- 32 children required 82 additional operations, most commonly for intolerance to pacing hardware.
Conclusions:
- Pediatric pacemaker implantation presents significant challenges, including device-related complications and mortality.
- Sick sinus syndrome, particularly after Mustard operations, poses a substantial risk.
- Further research into improved device reliability and management strategies for pediatric pacing is warranted.
Abstract:
Indications and results are presented for nearly all the cardiac pacemaker implantations in children in The Netherlands from 1963 through mid-1979. Five infants and 71 older children received a pacemaker for a total of 184 patient years. Two of the infants died within a week of birth; four children died after the pacemaker failed to control a sick sinus syndrome, which in three of them developed after a Mustard operation for transposition of the great arteries. A seventh death was due to a myocardial infarction soon after the implantation. In addition to the initial implantations a further 82 operations were necessary in 32 children for various reasons, intolerance to wires or to the pacing unit being the most frequent.