[Standards in pediatric pacemaker therapy].
Despite differences between pediatric and adult pacing have narrowed, implantation procedures in children require special considerations. Patients are physically smaller, they often suffer from complex cardiac defects necessitating further open heart surgery procedures. As there are no pacemakers and only some electrodes designed specially for pediatric pacing, selection of appropriate systems is important. At this time we care for 18 patients with a mean age of 11.5 +/- 6.5 years (= 138.6 +/- 78.4 months, range 10 to 280 months). 50% of them received a permanent pacemaker because of surgically induced heart block, 33.3% because of congenital complete heart block and 16.7% because of sick sinus syndrome. Mean age at first pacemaker implantation was 57 +/- 42 months (Range 0 to 120 months). 72.2% of these children had their first pacing system implanted in the abdominal wall with an epicardial electrode, 27.8% had endovenous endocardial electrodes with subpectoral generator placement. 72.2% of our patients had already revisions of their pacing systems, mean longevity time of pulse generators were 36.8 +/- 21.8 months. Upgrading from single chamber pacing to physiological AV-sequential dual chamber pacing was performed at a mean age of 9.0 +/- 2.8 years (= 108.3 +/- 33.9 months, range 66 to 154 months). By reviewing our patient data we want to discuss present standards and guidelines of surgical pacemaker therapy in children and how to prevent potential complications.
Antretter
H
H
Abteilung für Herzchirurgie, I. Chirurgische Universitätsklinik, Innsbruck.
Fritz
M
M
Bonatti
J
J
Fink
C
C
Mair
P
P
Furtwängler
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015716:Electrocardiography, Ambulatory; D004567:Electrodes, Implanted; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000151:congenital* / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D010138:Pacemaker, Artificial / Q000592:standards*; D011859:Radiography