Long-term follow-up after steroid-eluting epicardial pacemaker implantation in young children: a single centre experience.
OBJECTIVE
The purpose of this paper is the retrospective investigation of the clinical outcome and modes of failure leading to reoperation, as well as the report of the long-term results, in a group of young children who underwent epicardial pacemaker implantation.


RESULTS
Between 2000 and 2008, 45 young children underwent epicardial pacemaker implantation at 3.2 +/- 2.5 years of age for congenital (n = 27) or post-operative (n = 18) atrioventricular block. The follow-up time was 5.7 years +/- 5 months (range: 6 months to 7.3 years). Five lead malfunction events (11%) were detected during the follow-up time, three of which were due to ventricular lead fracture. All revisions could be performed without complications, and all revised pacemakers showed stable pacing and sensing parameters during long-term follow-up. The actuarial freedom from reoperation at 6 years was 88.8 +/- 2%. Median epicardial ventricular and atrial pacing thresholds were stable and excellent at the latest follow-up, with means of 1.1 +/- 0.5 V and 0.7 +/- 0.8 V, respectively.


CONCLUSIONS
In our patient cohort of 45 young children, epicardial pacing was associated with a satisfactory clinical outcome and acceptable long-term results. The major cause of reoperation in our series was lead fracture. Reoperations were performed at a low risk.
Papadopoulos
Nestoras
N
Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Hospital, Theodor-Stern-Kai 7, 60596 Frankfurt/Main, Germany. nestoras.papadopoulos@gmail.com
Rouhollapour
Amin
A
Kleine
Peter
P
Moritz
Anton
A
Bakhtiary
Farhad
F
D002304:Cardiac Pacing, Artificial / Q000379:methods* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D005500:Follow-Up Studies; D006327:Heart Block / Q000151:congenital / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D010138:Pacemaker, Artificial / Q000009:adverse effects; D010496:Pericardium; D012086:Reoperation; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D013256:Steroids