Fourteen years of implanted pacemakers in children.
Twenty-six children who had permanent pacemakers implanted at 6 hours to 11 years of age have been followed for up to 163 months. There were 14 children with surgical heart block, 9 with congenital heart block, 2 with postcatheterization complete heart block, and 1 with bradytachydysrhythmia syndrome. Eighteen of the 26 patients (69%) are still being paced with their original electrodes, some for more than eight years. Sixty pulse generators lasted an average of 17 months (range, 1 to 55 months). Five of the 26 patients (19%) are dead. Three died of noncorrectable heart disease, but there were 2 sudden unexplained deaths at home, both apparently due to sudden arrhtthmias. Both of these patients had received fixed-rate pulse generators, and 1 had a known potential for competing rhythms. The current optimal choices of equipment and techniques, including the role of synchronized, demand, lithium-powered, and nuclear-powered pulse generators, are discussed.
D000367:Age Factors; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003645:Death, Sudden; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000628:therapy*; D006331:Heart Diseases / Q000401:mortality; D006347:Heart Sounds; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010138:Pacemaker, Artificial / Q000295:instrumentation; D013530:Surgical Wound Infection / Q000188:drug therapy