Selective-site pacing in paediatric patients: a new application of the Select Secure system.
OBJECTIVE
The aim of this study was to evaluate the feasibility and reliability of selective-site pacing by means of a new lead system in a paediatric population. This lead system is composed of a 4.1 Fr, active-fixation lead and a steerable catheter that allows easy positioning in selective sites.


RESULTS
Thirty young patients (mean age 9.0 +/- 4.5 years, range 2-16 years) received a single- (10) or dual- (20) chamber pacemaker. The 3830 lead was implanted successfully in the targeted chambers in all patients. The selective RV sites of pacing in 26 of the patients were: 18 mid-septum, 5 outflow tract, 1 low-septum, and 2 LEVO-RV-Apex. In all patients, an intracardiac loop was left in order to avoid stretching of the lead with growth. Mean follow-up duration was 11 +/- 10 months. Atrial sensing and pacing thresholds were 3.2 +/- 1.7 mV and 0.8 +/- 0.6 V at 0.5 ms at implantation and 3.4 +/- 2.1 mV and 0.6 +/- 0.3 V at 0.5 ms at follow-up. Ventricular sensing and pacing thresholds were 12.1 +/- 4.9 and 0.7 +/- 0.4 V at 0.5 ms on implantation and 12.7 +/- 6.1 mV and 0.8 +/- 0.5 V at 0.5 ms at follow-up (P = NS). No adverse events were reported.


CONCLUSIONS
Select Secure is a promising system for selective-site pacing in children.
Cantù
Francesco
F
Electrophysiology, Cardiovascular Department, Ospedali Riuniti di Bergamo, Largo Barozzi 1, 24128 Bergamo, Italy. fcantu@ospedaliriuniti.bergamo.it
De Filippo
Paolo
P
Gabbarini
Fulvio
F
Borghi
Adele
A
Brambilla
Roberta
R
Ferrero
Paolo
P
Comisso
Jennifer
J
Marotta
Tiziana
T
De Luca
Alessandro
A
Gavazzi
Antonello
A
D000293:Adolescent; D000367:Age Factors; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D006801:Humans; D010138:Pacemaker, Artificial; D015203:Reproducibility of Results; D054088:Ventricular Septum / Q000503:physiopathology