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- Title:
Neonates and infants requiring life-long cardiac pacing: How reliable are epicardial leads through childhood?
- Document type:
- Journal Article
- Author(s):
- Stanner, C; Horndasch, M; Vitanova, K; Strbad, M; Ono, M; Hessling, G; Lange, R; Cleuziou, J
- Abstract:
- BACKGROUND: In the literature, data is lacking on mid-term results of epicardial pacemaker implantation in neonates and infants. Our aim was to evaluate the mid-term results of epicardial pacemakers implanted in infants under 1 year of age. METHODS AND RESULTS: We conducted a retrospective review of patients who underwent pacemaker implantation between 2000 and 2017. Pacemaker and lead parameters were reviewed at discharge, 2, 4 and more than 5 years after implantation. A total of 71 patients aged 4 ± 3 months and weighing 4 ± 2 kg were included in the study. Indications for pacemaker implantation were: acquired AV-block (n = 44), congenital AV block (n = 22), sick sinus syndrome (n = 4) and AV block type Mobitz II (n = 1). Median follow-up time was 5 years (range: 1 month-17 years). At 5 years of follow-up, atrial lead energy threshold for pacing decreased significantly (0.72 ± 0.71 μJ to 0.45 ± 0.35 μJ; P < 0.001) but was stable for ventricular leads (0.57 μJ [0.05; 39.47] to 0.64 μJ [0.13; 9.45], P = 0.97). Atrial lead impedance increased significantly (569 ± 137 Ω to 603 ± 134 Ω, P < 0.001), whereas ventricular lead impedance decreased (603 ± 202 Ω to 490 ± 150 Ω, P < 0.001) after 5 years. Repeat operations were required for generator change (n = 55), lead exchange (n = 17) and infection (n = 1). At 2, 5 and 10 years, atrial lead survival was 96%, 91% and 76% and ventricular lead survival was 94%, 82% and 75%, respectively (P = 0.45). CONCLUSION: Stable pacing thresholds after 5 years indicated that epicardial pacemakers are safe for infants under 1 year of age until at least school enrolment age. However, due to stimulation at higher heart rates in infancy, battery depletion is a frequent occurrence.
- Journal title abbreviation:
- Int J Cardiol
- Year:
- 2019
- Journal volume:
- 297
- Pages contribution:
- 43-48
- Fulltext / DOI:
- doi:10.1016/j.ijcard.2019.10.008
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/31630820
- Print-ISSN:
- 0167-5273
- TUM Institution:
- Klinik für Herz- und Gefäßchirurgie (Prof. Lange); Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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