[Physiological mode of pacing in pediatrics].
The concept of physiologic pacing is often primarily to involve the preservation of atrioventricular synchrony. Nevertheless, specially in children there are other mechanisms different than atrial filling to improve cardiac output such as heart rate increase with exercise. Taking as physiologic pacing those modes of pacing improving hemodynamic condition of the patient we must add to the DDD, the DDDR and SSIR modes of pacing. In this report our experience with 70 consecutive children paced in physiological mode of pacing is described: 51 in SSIR mode, DDD in 16, and DDDR in 3 cases. In five out of the 16 cases with DDD mode it was found an unidirectional crosstalk and in two atrial sensing failure (failure rate with DDD of 47.75% at 48 months of follow-up). In 26 children with rate responsive pacing by means of activity sensing a treadmill exercise test according to Bruce protocol was performed found a significant increase in both, heart rate and maximal work capacity, associated to an improvement in the clinical status and no evidence of arrhythmias in any case. In conclusion, rate responsive pacing by means of activity sensing in children is an adequate, reliable and effective physiological mode of pacing.
Cabo
J
J
Servicio de Cirugía Cardiovascular, Hospital Infantil La Paz, Universidad Autónoma, Madrid.
Cordovilla
G
G
Benito
F
F
Moreno
F
F
Alvarez
F
F
D000293:Adolescent; D002304:Cardiac Pacing, Artificial; D002648:Child; D002675:Child, Preschool; D006321:Heart / Q000502:physiology / Q000503:physiopathology; D006331:Heart Diseases / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007223:Infant
Estimulación fisiológica en pediatría.