Abstract
Aggressive diagnosis and treatment, both medical and surgical, for congenital or acquired heart disease in children have resulted in an increased need for permanent cardiac pacing systems. However, frequent premature pacemaker revisions have been necessary for many reasons, including lead fractures, noncapture due to increasing threshold, and wound infection or skin breakdown over the pacemaker generator. 1–3 Most pacemaker systems in children have used epicardial leads because of concern for lead dislodgement or damage to intracardiac structures, large lead size relative to small venous access, and difficulty in implanting relatively large pacemaker generators in a suitable prepectoral location. Recent changes in design of pacemaker generators and leads have made use of transvenous systems more tenable even in younger children who require permanent cardiac pacing. 4 However, little information has been reported regarding long-term results of transvenous pacemakers in children.
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