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Cardiac pacing in children
1Division of Pediatric Cardiology, Babies' & Children's Hospital of New York, NY 10032, USA.
Insights
Cardiac pacing in children is expanding beyond traditional uses to treat complex heart conditions. Programmable pacemakers offer versatility for improved hemodynamics in pediatric patients needing long-term therapy.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Biomedical Engineering
Background:
- Cardiac pacing indications in pediatric patients are broadening.
- Traditional uses include sinus and atrioventricular nodal disease.
- New applications address complex congenital heart disease and genetic conditions.
Purpose of the Study:
- To review the expanding indications for cardiac pacing in pediatric patients.
- To highlight the role of programmable pacemaker features in managing pediatric cardiac conditions.
- To discuss the benefits of pacing in specific pediatric heart diseases.
Main Methods:
- Literature review of current pediatric cardiac pacing applications.
- Analysis of traditional and novel indications for pacing in children.
- Discussion of pacemaker technology and its impact on pediatric hemodynamics.
Main Results:
- Expanded indications include post-surgical tachyarrhythmias, hypertrophic cardiomyopathy, and congenital long QT syndrome.
- Benefits in children are largely anecdotal, unlike well-documented adult data.
- Programmable features like rate-response enhance pacemaker versatility.
Conclusions:
- Cardiac pacing offers expanding therapeutic options for pediatric heart conditions.
- Programmable pacemakers are crucial for achieving normal hemodynamics in children.
- Further research is needed to validate benefits in pediatric populations.
Abstract:
Indications for cardiac pacing in pediatric patients continue to expand. In addition to its traditional use in sinus and atrioventricular nodal disease, applications for cardiac pacing now include treatment of tachyarrhythmias after repair of congenital heart disease, reduction of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, and prevention of sudden death in the congenital long QT syndrome. Whereas many benefits have been well documented in adults, they remain anecdotal in children. Programmable features such as rate-response and antitachycardia pacing contribute to pacemaker versatility and facilitate the achievement of normal hemodynamics in children requiring long-term pacing therapy.