Abstract
BackgroundTo analyze the 10-year experience of single chamber permanent epicardial pacemaker placement for children with congenital heart diseases (CHD) after surgical repair.MethodsBetween 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).ResultsAcute 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).ConclusionHigh-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.
Highlights
To analyze the 10-year experience of single chamber permanent epicardial pacemaker placement for children with congenital heart diseases (CHD) after surgical repair
Nine children were excluded because they were associated with congenital atrioventricular block (AVB) and pacemaker was implanted during the surgical repair
Except for a patient that suffered early postoperative death, who died from the low cardiac output syndrome after surgical repair for complex congenital heart disease, all patients were discharged from the hospital
Summary
To analyze the 10-year experience of single chamber permanent epicardial pacemaker placement for children with congenital heart diseases (CHD) after surgical repair. The main indication for permanent pacemaker implantation in children is high-degree congenital atrioventricular block (AVB) with a frequency of about 1/ 2000 [2, 3]. Another important indication is high-degree AVB following open-heart surgery, occurring with an incidence of 1 %. It is the main reason for placement of Because of low economic statuses and undeveloped insurance systems, the single chamber pacemakers are utilized in many heart center for sick children in China. The current study aimed to review and analyze our 10-
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