Long term follow up of permanent pacing in children

Abstract

To evaluate the experience and the long-term results of pacemaker (PM) therapy in children. We performed a retrospective analysis of all patients (pts) who underwent PM implantation at King Faisal Heart Institute. Data obtained include: demographics, diagnosis, indication for pacing, and follow up evaluation. Between 1985 and 2012, 516 pts had PMs implanted; mean age is 2.4 years (2days–18 years). The most frequent indication are: surgical AV block 392 pts (76%), congenital AV block 73 pts (14%), sinus node dysfunction 38 pts (7%). Surgical AV block was encountered after relieve of left ventricular outflow tract obstruction, ventricular septal defect (VSD) repair, and repair of complex lesion associated with ventricular inversion. Congenital AV block was isolated in 58 pts; the remaining had associated congenital heart defects (ventricular inversion 10, VSD 2, coarctation 2, truncus arteriosus 1). The initial PM system was epicardial in 412 pts (80%). After a mean follow up of 4.2 years (1 month–25 years), 105 pts had 159 revision procedures (lead malfunction 73, battery depletion 77, PM infection 9). Lead malfunction was more encountered with epicardial leads. There was no mortality directly related to the PM implantation procedure or function however there were 21 pts lost during the follow up and 14 pts (3%) had nonpacemaker related death. Pacemakers are safe and effective therapy in children. Epicardial lead malfunction is a frequent reason for pacemaker revision.