Sick sinus syndrome and diffuse impairment of the conduction system in a child: successful pacing with a steroid eluting endocardial pacing lead.
A 9-year-old patient who had had a syncope was found to have atrial flutter in a resting electrocardiogram (ECG). Brief phases of sinus arrest had previously occurred after drug conversion to sinus rhythm. Structural heart disease was excluded by cardiac catheterization and angiography. Electrophysiologic study revealed a sick sinus syndrome, associated with diffuse impairment of the conduction system (supra-, infra-, and intrahisian block). Epimyocardial and an endocardial pacemaker implantation failed because of high stimulation threshold, after 3 years and 2 weeks, respectively. At the third implantation a steroid-eluting endocardial pacing lead was used and satisfactory pacing was still present 2 years later.
Capucci
A
A
Istituto di Malattie dell'Apparato Cardiovascolare, Università degli Studi di Bologna, Italy.
Boriani
G
G
Galli
R
R
Picchio
F M
FM
Pierangeli
A
A
Magnani
B
B
D001282:Atrial Flutter / Q000150:complications / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002648:Child; D006327:Heart Block / Q000150:complications / Q000628:therapy*; D006801:Humans; D007854:Lead; D008297:Male; D010138:Pacemaker, Artificial; D012804:Sick Sinus Syndrome / Q000150:complications / Q000628:therapy*; D013256:Steroids
D013256:Steroids; D007854:Lead