title: Long-term follow-up after steroid-eluting epicardial pacemaker implantation in young children: a single centre experience.
abstract: 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.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Hospital, Theodor-Stern-Kai 7, 60596 Frankfurt/Main, Germany. nestoras.papadopoulos@gmail.com
authors.forename: Nestoras
authors.initials: N
authors.lastname: Papadopoulos
authors.forename: Amin
authors.initials: A
authors.lastname: Rouhollapour
authors.forename: Peter
authors.initials: P
authors.lastname: Kleine
authors.forename: Anton
authors.initials: A
authors.lastname: Moritz
authors.forename: Farhad
authors.initials: F
authors.lastname: Bakhtiary
mesh_terms: 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
chemical_list: D013256:Steroids