Trends in pediatric cardiac pacing.
OBJECTIVE
To review retrospectively a 31-year experience with pediatric cardiac pacing at the University of Toronto, with an emphasis on the changing trends in pacemaker implantation in infants and children.


METHODS
Data were obtained from the pediatric pacemaker follow-up clinic at The Hospital for Sick Children, Toronto, Ontario or from the referring pediatric centre. Follow-up was normally continued until the death of the child or referral to an adult hospital at age 18 years.


METHODS
The study comprised 397 children (under 18 years of age) who underwent initial pacemaker implantation at The Hospital for Sick Children between January 1962 and December 31, 1992. Follow-up was 99% complete (five children lost) and ranged from one month to 32 years (mean 6.5 years).


RESULTS
The use of endocardial versus epicardial leads increased significantly over time (P < 0.001). In addition, significantly more children receiving pacemakers had sick sinus syndrome (P < 0.001). No difference in survival was found between children paced by endocardial versus epicardial leads or between children paced for sick sinus syndrome versus atrioventricular block. The frequency of exit block, by lifetable analysis, did not differ between children who received epicardial versus endocardial leads.


CONCLUSIONS
Guidelines for permanent pacemaker implantation in children continue to evolve as developments in lead technology alter trends in pediatric cardiac pacing.
Division of Cardiovascular Surgery, Sunnybrook Health Science Centre, Hospital for Sick Children, Toronto, Ontario.
V
V
Rao
W G
WG
Williams
R H
RH
Hamilton
M G
MG
Williams
B S
BS
Goldman
R M
RM
Gow
D000293:Adolescent; D000367:Age Factors; D002170:Canada; D002304:Cardiac Pacing, Artificial; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000601:surgery*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D010138:Pacemaker, Artificial / Q000639:trends; D015996:Survival Rate; D013614:Tachycardia, Paroxysmal / Q000601:surgery; D016896:Treatment Outcome