title: Single chamber permanent epicardial pacing for children with congenital heart disease after surgical repair.
abstract: BACKGROUND
  To analyze the 10-year experience of single chamber permanent epicardial pacemaker placement for children with congenital heart diseases (CHD) after surgical repair.
  
  
  METHODS
  Between 2002 and 2014, a total of 35 patients with CHD (age: 26.9 ± 23.2 months, weight: 9.7 ± 5.6 kg) received permanent epicardial pacemaker placement following corrective surgery. Echocardiography and programming information of the pacemaker, as well as major adverse cardiac events (MACE) as heart failure or sudden death, were recorded during follow-up (46.8 ± 33.8 months).
  
  
  RESULTS
  Acute ventricular stimulation threshold was 1.34 ± 0.72 V and no significant increase was observed at the last follow-up as 1.37 ± 0.81 V (p = 0.93). Compared with initial pacemaker implantation, the last follow-up didn't show significant increases in impedance (p = 0.327) or R wave (p = 0.635). Four patients received pacemaker replacement because of battery depletion. 7/35 (20 %) of patients experienced MACE. Although the age and body weight were similar between patients with and without MACE, the patients with MACE were with complex CHD (100 % vs.55.6 %, p = 0.04).
  
  
  CONCLUSIONS
  High-degree iatrogenic atrioventricular block was the primary reason for placement of epicardial pacemaker for patients with CHD after surgical repair. Pacemaker placement with the steroid-eluting leads results in acceptable outcomes, however, the pacemaker type should be optimized for the children with complex CHD.
authors.affiliation: Department of Cardiac Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China.|Center for Pediatric Cardiac Surgery, National Center for Cardiovascular Diseases and Fuwai Hospital, Beijing, China.|Department of Cardio-Thoracic Surgery, Shouguang People's Hospital, Shouguang, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Center for Pediatric Cardiac Surgery, National Center for Cardiovascular Diseases and Fuwai Hospital, Beijing, China.
authors.forename: Yiwei
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiac Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China. cwzou@hotmail.com.
authors.forename: Chengwei
authors.initials: C
authors.lastname: Zou
authors.affiliation: Center for Pediatric Cardiac Surgery, National Center for Cardiovascular Diseases and Fuwai Hospital, Beijing, China. drzhanghao@126.com.|Peking Union Medical College and Chinese Academy of Medical Sciences, 167 Beilishi Road, Beijing, 100037, P.R. China. drzhanghao@126.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
mesh_terms: D054537:Atrioventricular Block / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D010138:Pacemaker, Artificial; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Congenital heart disease; Iatrogenic atrioventricular block; Permanent epicardial pacemaker