The efficacy of ventricular pacing with device automaticity in paediatric patients.
OBJECTIVE
To compare pacemaker reprogramming and re-intervention rates in children with AutoCapture (AC) and conventionally (Conv) programmed devices, and to assess reliability of device automaticity.


RESULTS
Data of children with AC (group AC, n = 49) and conventionally programmed devices (group Conv, n = 41) were analysed. A total of 1106 outpatient visits and 147 Holter recordings were screened for device reprogramming and invasive re-intervention. At 2 and 5 years, freedom from reprogramming differed significantly between groups (AC: 63/35% vs. Conv: 13/4%; P < 0.0001), whereas freedom from re-intervention was not different (AC: 95/90% vs. Conv: 95/85%; P = 0.26). Mean yearly rate of reprogramming was lower in group AC (AC: 0.67 +/- 0.55 vs. Conv: 1.13 +/- 0.82; P = 0.005). Follow-up duration correlated with a decreasing number of reprogramming per year in group Conv (rho = -0.73, P < 0.001). No ventricular output reprogramming was required in group AC. Holter recordings required 0.07 +/- 0.13 reprogramming per year in group Conv, none in group AC (P < 0.001). Holter-detected lead dysfunction prompted re-intervention in one patient of each group.


CONCLUSIONS
Estimated freedom from as well as total yearly rate of device reprogramming was favourable for AC-programmed devices. No difference was seen for the incidence of invasive re-interventions. AC ventricular output control was effective. Structured device follow-up and Holter recordings in specific patient groups remain mandatory for all devices in paediatric patients.
Tomaske
Maren
M
Division of Paediatric Cardiology, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland. maren.tomaske@kispi.uzh.ch
Harpes
Paul
P
Woy
Natascha
N
Bauersfeld
Urs
U
D000293:Adolescent; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015716:Electrocardiography, Ambulatory; D004869:Equipment Safety; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018670:Monitoring, Ambulatory / Q000379:methods*; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D012984:Software; D016896:Treatment Outcome; D016276:Ventricular Function / Q000502:physiology*