Document Detail

Long Term Atrial and Ventricular Epicardial Pacemaker Lead Survival After Cardiac Operations in Pediatric Congenital Heart Disease Patients.
MedLine Citation:
PMID:  25484105     Owner:  NLM     Status:  Publisher    
BACKGROUND: Multiple cardiac operations and resultant myocardial scarring have been implicated in the overall diminished performance of epicardial pacing systems in patients with congenital heart disease (CHD).
OBJECTIVE: We evaluated the long-term permanent epicardial pacing lead survival in patients with CHD who had epicardial lead placement in association with surgical repair or palliation.
METHODS: A retrospective review of patients who had implantation of epicardial pacing systems between January 1984 and June 2010 was conducted. Inclusion criteria were: 1) presence of CHD and 2) cardiac operation(s) concomitant with or prior to initial permanent epicardial lead implantation. Patients were divided into 2 anatomical groups: single ventricle (SV) and bi-ventricle (Bi-V).
RESULTS: Epicardial leads were implanted in 663 patients during the study period. One hundred fifty-five patients (76 SV; 79 Bi-V) were included, resulting in 259 leads and 946 lead-years of follow-up. There were 2 deaths and 8 infections attributable to pacemaker placement. Overall atrial lead survival at 1, 2, 5 and 10 years (99%; 93%; 83%; 72%) was comparable to that of ventricular leads (97%; 90%; 74%; 60%) (p=0.540) and were also similar between SV and Bi-V patients. Cox regression analysis demonstrated that SV palliation and an earlier era of lead implantation (1984-1999) was significantly associated with ventricular, but not atrial, lead malfunction.
CONCLUSIONS: Epicardial leads had acceptable longevity despite cardiac operations for complex CHD, suggesting the long-term reliability of this pacing method.
Kelvin C Lau; J William Gaynor; Stephanie M Fuller; Karen Smoots; Maully J Shah
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-12-4
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-8     Completed Date:  -     Revised Date:  2014-12-9    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Inc.
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