title: Integrated home monitoring predicts lead failure in a pacemaker dependent 4-year-old girl.
abstract: A 4-year-old girl with post-surgical complete atrioventricular block received an epicardial dual chamber pacemaker system. During further growth intermittent exit block occurred, first misinterpreted as neurological seizures. The epicardial lead was replaced using a transvenous approach, and a pacemaker with an integrated home monitoring facility was implanted. After her discharge, a rise in the pacing threshold automatically initiated an event message. On the basis of this information, the patient was called in and imminent dislodgement of the ventricular lead was diagnosed by x-ray. The lead was repositioned and was found stable over 1-year follow-up.
authors.affiliation: German Paediatric Heart Centre Sankt Augustin, Department for Cardiology, Arnold-Janssen-Str. 29, D-53757 Sankt Augustin, Germany. p.zartner@asklepios.com
authors.forename: P A
authors.initials: PA
authors.lastname: Zartner
authors.forename: R P
authors.initials: RP
authors.lastname: Handke
authors.forename: A M
authors.initials: AM
authors.lastname: Brecher
authors.forename: M B E
authors.initials: MB
authors.lastname: Schneider
mesh_terms: D002675:Child, Preschool; D015716:Electrocardiography, Ambulatory; D004567:Electrodes, Implanted; D004868:Equipment Failure; D005260:Female; D006327:Heart Block / Q000503:physiopathology* / Q000628:therapy*; D018575:Home Care Services, Hospital-Based; D006801:Humans; D010138:Pacemaker, Artificial