Permanent epicardial pacing in pediatric patients: 12-year experience at a single center

Jae Gun Kwak, Soo Jin Kim, Jin Young Song, Eun Young Choi, Sangyun Lee, Woo Sup Shim, Chang Ha Lee, Cheul Lee, Chun Soo Park

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Permanent cardiac pacing is not often done in children, and when done is usually accomplished through epicardial pacing. We reviewed a 12-year experience with the implantation of epicardial pacemakers by our clinical group. Methods: Fifty-three patients who underwent their first implantation of an epicardial pacemaker before the age of 18 years and between 1997 and 2009 were included in our study. The mean age of the patients at the time of first pacemaker implantation was 5.7 ± 4.8 years. Indications for pacemaker implantation included postoperative or congenital atrioventricular block and sinus node dysfunction. The patients underwent 105 operations for the replacement of pacemaker pulse generators and 75 operations for the replacement of pacemaker leads. The most commonly used generator mode was the rate-responsive accelerometer-based (DDDR) mode, which was used in 40.9% of the patients. We used more non-steroid-eluting leads (70.1%) than steroid-eluting leads (29.1%). Results: The overall duration of follow-up in the study was 8.0 ± 4.5 years (range, 2.1 months to approximately 17.0 years). Freedom from the need for generator replacement was 98.0%, 60.7%, and 11.1% at 1, 5, and 8 years, respectively. A tendency toward early generator exhaustion was observed among younger patients (p = 0.058). The generator mode used for pacing did not significantly affect generator longevity. Freedom from the need for lead replacement was 98.3%, 83.8%, and 63.6% at 1, 5, and 10 years, respectively. The mean longevity of the leads used in the study was 10.8 ± 0.8 years. Neither patient age at the time of lead implantation nor type of lead significantly affected lead longevity. Conclusions: Lead longevity was sufficiently long and did not vary significantly according to type of lead. Generator longevity was not affected by lead type, generator mode, or patient age at the time of pacemaker implantation.

Original languageEnglish
Pages (from-to)634-639
Number of pages6
JournalAnnals of Thoracic Surgery
Volume93
Issue number2
DOIs
StatePublished - 1 Feb 2012

Fingerprint

Pediatrics
Sick Sinus Syndrome
Atrioventricular Node
Atrioventricular Block
Lead
Steroids

Keywords

  • CAVB
  • CRT
  • DILV
  • DORV
  • MET
  • PPM
  • TOF
  • VSD
  • cardiac resynchronization therapy
  • cc-TGA
  • complete atrioventricular block
  • congenitally corrected transposition of great arteries
  • double inlet left ventricle
  • double outlet right ventricle
  • minimal energy threshold
  • permanent pacemaker
  • tetralogy of Fallot
  • ventricular septal defect

Cite this

Kwak, Jae Gun ; Kim, Soo Jin ; Song, Jin Young ; Choi, Eun Young ; Lee, Sangyun ; Shim, Woo Sup ; Lee, Chang Ha ; Lee, Cheul ; Park, Chun Soo. / Permanent epicardial pacing in pediatric patients : 12-year experience at a single center. In: Annals of Thoracic Surgery. 2012 ; Vol. 93, No. 2. pp. 634-639.
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abstract = "Background: Permanent cardiac pacing is not often done in children, and when done is usually accomplished through epicardial pacing. We reviewed a 12-year experience with the implantation of epicardial pacemakers by our clinical group. Methods: Fifty-three patients who underwent their first implantation of an epicardial pacemaker before the age of 18 years and between 1997 and 2009 were included in our study. The mean age of the patients at the time of first pacemaker implantation was 5.7 ± 4.8 years. Indications for pacemaker implantation included postoperative or congenital atrioventricular block and sinus node dysfunction. The patients underwent 105 operations for the replacement of pacemaker pulse generators and 75 operations for the replacement of pacemaker leads. The most commonly used generator mode was the rate-responsive accelerometer-based (DDDR) mode, which was used in 40.9{\%} of the patients. We used more non-steroid-eluting leads (70.1{\%}) than steroid-eluting leads (29.1{\%}). Results: The overall duration of follow-up in the study was 8.0 ± 4.5 years (range, 2.1 months to approximately 17.0 years). Freedom from the need for generator replacement was 98.0{\%}, 60.7{\%}, and 11.1{\%} at 1, 5, and 8 years, respectively. A tendency toward early generator exhaustion was observed among younger patients (p = 0.058). The generator mode used for pacing did not significantly affect generator longevity. Freedom from the need for lead replacement was 98.3{\%}, 83.8{\%}, and 63.6{\%} at 1, 5, and 10 years, respectively. The mean longevity of the leads used in the study was 10.8 ± 0.8 years. Neither patient age at the time of lead implantation nor type of lead significantly affected lead longevity. Conclusions: Lead longevity was sufficiently long and did not vary significantly according to type of lead. Generator longevity was not affected by lead type, generator mode, or patient age at the time of pacemaker implantation.",
keywords = "CAVB, CRT, DILV, DORV, MET, PPM, TOF, VSD, cardiac resynchronization therapy, cc-TGA, complete atrioventricular block, congenitally corrected transposition of great arteries, double inlet left ventricle, double outlet right ventricle, minimal energy threshold, permanent pacemaker, tetralogy of Fallot, ventricular septal defect",
author = "Kwak, {Jae Gun} and Kim, {Soo Jin} and Song, {Jin Young} and Choi, {Eun Young} and Sangyun Lee and Shim, {Woo Sup} and Lee, {Chang Ha} and Cheul Lee and Park, {Chun Soo}",
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Permanent epicardial pacing in pediatric patients : 12-year experience at a single center. / Kwak, Jae Gun; Kim, Soo Jin; Song, Jin Young; Choi, Eun Young; Lee, Sangyun; Shim, Woo Sup; Lee, Chang Ha; Lee, Cheul; Park, Chun Soo.

In: Annals of Thoracic Surgery, Vol. 93, No. 2, 01.02.2012, p. 634-639.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Permanent epicardial pacing in pediatric patients

T2 - 12-year experience at a single center

AU - Kwak, Jae Gun

AU - Kim, Soo Jin

AU - Song, Jin Young

AU - Choi, Eun Young

AU - Lee, Sangyun

AU - Shim, Woo Sup

AU - Lee, Chang Ha

AU - Lee, Cheul

AU - Park, Chun Soo

PY - 2012/2/1

Y1 - 2012/2/1

N2 - Background: Permanent cardiac pacing is not often done in children, and when done is usually accomplished through epicardial pacing. We reviewed a 12-year experience with the implantation of epicardial pacemakers by our clinical group. Methods: Fifty-three patients who underwent their first implantation of an epicardial pacemaker before the age of 18 years and between 1997 and 2009 were included in our study. The mean age of the patients at the time of first pacemaker implantation was 5.7 ± 4.8 years. Indications for pacemaker implantation included postoperative or congenital atrioventricular block and sinus node dysfunction. The patients underwent 105 operations for the replacement of pacemaker pulse generators and 75 operations for the replacement of pacemaker leads. The most commonly used generator mode was the rate-responsive accelerometer-based (DDDR) mode, which was used in 40.9% of the patients. We used more non-steroid-eluting leads (70.1%) than steroid-eluting leads (29.1%). Results: The overall duration of follow-up in the study was 8.0 ± 4.5 years (range, 2.1 months to approximately 17.0 years). Freedom from the need for generator replacement was 98.0%, 60.7%, and 11.1% at 1, 5, and 8 years, respectively. A tendency toward early generator exhaustion was observed among younger patients (p = 0.058). The generator mode used for pacing did not significantly affect generator longevity. Freedom from the need for lead replacement was 98.3%, 83.8%, and 63.6% at 1, 5, and 10 years, respectively. The mean longevity of the leads used in the study was 10.8 ± 0.8 years. Neither patient age at the time of lead implantation nor type of lead significantly affected lead longevity. Conclusions: Lead longevity was sufficiently long and did not vary significantly according to type of lead. Generator longevity was not affected by lead type, generator mode, or patient age at the time of pacemaker implantation.

AB - Background: Permanent cardiac pacing is not often done in children, and when done is usually accomplished through epicardial pacing. We reviewed a 12-year experience with the implantation of epicardial pacemakers by our clinical group. Methods: Fifty-three patients who underwent their first implantation of an epicardial pacemaker before the age of 18 years and between 1997 and 2009 were included in our study. The mean age of the patients at the time of first pacemaker implantation was 5.7 ± 4.8 years. Indications for pacemaker implantation included postoperative or congenital atrioventricular block and sinus node dysfunction. The patients underwent 105 operations for the replacement of pacemaker pulse generators and 75 operations for the replacement of pacemaker leads. The most commonly used generator mode was the rate-responsive accelerometer-based (DDDR) mode, which was used in 40.9% of the patients. We used more non-steroid-eluting leads (70.1%) than steroid-eluting leads (29.1%). Results: The overall duration of follow-up in the study was 8.0 ± 4.5 years (range, 2.1 months to approximately 17.0 years). Freedom from the need for generator replacement was 98.0%, 60.7%, and 11.1% at 1, 5, and 8 years, respectively. A tendency toward early generator exhaustion was observed among younger patients (p = 0.058). The generator mode used for pacing did not significantly affect generator longevity. Freedom from the need for lead replacement was 98.3%, 83.8%, and 63.6% at 1, 5, and 10 years, respectively. The mean longevity of the leads used in the study was 10.8 ± 0.8 years. Neither patient age at the time of lead implantation nor type of lead significantly affected lead longevity. Conclusions: Lead longevity was sufficiently long and did not vary significantly according to type of lead. Generator longevity was not affected by lead type, generator mode, or patient age at the time of pacemaker implantation.

KW - CAVB

KW - CRT

KW - DILV

KW - DORV

KW - MET

KW - PPM

KW - TOF

KW - VSD

KW - cardiac resynchronization therapy

KW - cc-TGA

KW - complete atrioventricular block

KW - congenitally corrected transposition of great arteries

KW - double inlet left ventricle

KW - double outlet right ventricle

KW - minimal energy threshold

KW - permanent pacemaker

KW - tetralogy of Fallot

KW - ventricular septal defect

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U2 - 10.1016/j.athoracsur.2011.09.072

DO - 10.1016/j.athoracsur.2011.09.072

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VL - 93

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EP - 639

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

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