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Trends in pediatric cardiac pacing
V Rao1, W G Williams, R H Hamilton
1Division of Cardiovascular Surgery, Sunnybrook Health Science Centre, Hospital for Sick Children, Toronto, Ontario.
The Canadian Journal of Cardiology
|December 1, 1995
Summary
Pediatric cardiac pacing trends show increased use of endocardial leads and a rise in sick sinus syndrome diagnoses. Lead type and diagnosis did not impact survival rates in children over 31 years.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Cardiac Electrophysiology
Background:
- Cardiac pacing in children has evolved significantly over decades.
- Technological advancements influence pacemaker implantation strategies.
- Understanding long-term outcomes is crucial for pediatric cardiac care.
Purpose of the Study:
- To retrospectively analyze 31 years of pediatric cardiac pacing experience.
- To identify changing trends in pacemaker implantation in infants and children.
- To evaluate outcomes related to lead type and diagnosis.
Main Methods:
- Retrospective review of 397 children (under 18) undergoing initial pacemaker implantation (1962-1992).
- Data collected from a dedicated pediatric pacemaker follow-up clinic.
- Long-term follow-up (mean 6.5 years) assessed outcomes.
Main Results:
- Significant increase in endocardial versus epicardial lead use over time (P < 0.001).
- Significant rise in sick sinus syndrome as a primary diagnosis (P < 0.001).
- No significant difference in survival or exit block frequency between lead types or diagnoses.
Conclusions:
- Pediatric cardiac pacing guidelines are dynamic, influenced by lead technology.
- Endocardial leads are increasingly preferred in pediatric pacemaker implantation.
- Continued research is needed to optimize pacing strategies for children.