|Predictors affecting durability of epicardial pacemaker leads in pediatric patients.|
|PMID: 18242269 Owner: NLM Status: MEDLINE|
|OBJECTIVES: Despite pacemaker therapy in children and adolescents favoring an initial epicardial approach, predictors of lead failure have not been well clarified. The aim of this study was to assess the long-term outcomes and to determine predictors affecting lead durability in pediatric pacing therapy. METHODS: We reviewed the outcomes of 109 consecutive pacing leads implanted in 55 patients (median age, 5.2 years; range, 31 days-15.8 years), including 38 atrial and 71 ventricular leads. They consisted of 58 (53%) fishhooks, 37 (34%) screw-in leads, and 14 (13%) steroid-eluting suture-on leads. Seventy (64%) were implanted in patients with structural heart disease. RESULTS: The leads were followed for a median of 6.4 years (range, 3 days-22.9 years). Lead failure occurred in 29 leads (27%; median of 8.4 years after implantation). Exit block or elevation of pacing threshold was the most common cause (n = 18), but failures did not directly cause patient death. The overall 1-, 5-, 10-, and 15-year lead survivals were 100%, 89.0%, 72.5%, and 55.5%, respectively. Multivariate Cox analysis revealed concurrent structural heart disease (relative risk, 2.85; 95% confidence interval, 1.27-6.42; P = .011) to be the only significant predictor of lead failure. CONCLUSIONS: Epicardial leads provide a reliable technique for managing rhythmic disturbance problems in the pediatric population. The only significant predictor of lead failure is the presence of structural heart disease.|
|Hiroomi Murayama; Masanobu Maeda; Hajime Sakurai; Akihiko Usui; Yuichi Ueda|
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|Type: Journal Article|
|Title: The Journal of thoracic and cardiovascular surgery Volume: 135 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2008 Feb|
|Created Date: 2008-02-04 Completed Date: 2008-03-10 Revised Date: -|
Medline Journal Info:
|Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States|
|Languages: eng Pagination: 361-6 Citation Subset: AIM; IM|
|Department of Cardiovascular Surgery, Social Insurance Chukyo Hospital, Nagoya, Japan. email@example.com|
|APA/MLA Format Download EndNote Download BibTex|
Arrhythmias, Cardiac / diagnosis*, etiology, mortality, therapy*
Cardiac Pacing, Artificial / methods*
Heart Defects, Congenital / complications
Proportional Hazards Models
Severity of Illness Index
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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