Document Detail

Axillary versus infraclavicular placement for endocardial heart rhythm devices in patients with pediatric and congenital heart disease.
MedLine Citation:
PMID:  21094368     Owner:  NLM     Status:  MEDLINE    
Our objective was to evaluate the implant and mid-term outcomes of transvenous pacemaker or internal cardioverter-defibrillator placement by alternative axillary approaches compared to the infraclavicular approach in a pediatric and congenital heart disease population. We conducted a retrospective review of all patients with new endocardial heart rhythm devices placed at 4 pediatric arrhythmia centers. A total of 317 patients were included, 63 had undergone a 2-incision axillary approach, 51 a retropectoral axillary approach, and 203 an infraclavicular approach. Congenital heart disease was present in 62% of the patients. The patients with the 2-incision axillary approach were younger and smaller. The patients with the retropectoral axillary approach were less likely to have undergone previous cardiac surgery and were more likely to have had an internal cardioverter-defibrillator placed. The duration of follow-up was 2.4 ± 1.9 years for the 2-incision axillary, 2.6 ± 2.6 years for retropectoral axillary, and 3.5 ± 1.4 years for the infraclavicular technique (p = 0.01). No differences were seen in implant characteristics, lead longevity, implant complications, lead fractures or dislodgements, inappropriate internal cardioverter-defibrillator discharges, or device infections among the 3 groups. In conclusion, our data support that the outcomes of axillary approaches are comparable to the infraclavicular approach for endocardial heart rhythm device placement and that axillary approaches should be considered a viable option in patients with pediatric and congenital heart disease.
Christopher M Rausch; Benjamin H Hughes; Martin Runciman; Ian H Law; David J Bradley; Mathur Sujeev; Abdul Duke; Michael Schaffer; Kathryn K Collins
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2010-10-19
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1646-51     Citation Subset:  AIM; IM    
Copyright Information:
Published by Elsevier Inc.
Division of Pediatric Cardiology, Children's Hospital, University of Colorado, Denver, Colorado, USA.
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MeSH Terms
Defibrillators, Implantable*
Electric Countershock / methods*
Follow-Up Studies
Heart Defects, Congenital / physiopathology,  therapy*
Heart Rate / physiology*
Prosthesis Implantation / methods*
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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