| Surgical approaches to epicardial pacemaker placement: does pocket location affect lead survival? | |
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MedLine Citation:
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PMID: 20690018 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Permanent cardiac pacing in pediatric patients presents challenges related to small patient size, complex anatomy, electrophysiologic abnormalities, and limited access to cardiac chambers. Epicardial pacing currently remains the conventional technique for infants and patients with complex congenital heart disease. Pacemaker lead failure is the major source of failure for such epicardial systems. The authors hypothesized that a retrocostal surgical approach would reduce the rate of lead failure due to fracture compared with the more traditional subrectus and subxiphoid approaches. To evaluate this hypothesis, a retrospective chart review analyzed patients with epicardial pacemaker systems implanted or followed at Rady Children's Hospital San Diego between January 1980 and May 2007. The study cohort consisted of 219 patients and a total of 620 leads with epicardial pacemakers. Among these patients, 84% had structural congenital heart disease, and 45% were younger than 3 years at time of the first implantation. The estimated lead survival was 93% at 2 years and 83% at 5 years. The majority of leads failed due to pacing problems (54%), followed by lead fracture (31%) and sensing problems (14%). When lead failure was adjusted for length of follow-up period, no significant differences in the rates of failure by pocket location were found. |
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Authors:
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Brian J Lichtenstein; David P Bichell; Dana M Connolly; John J Lamberti; Suzanne M Shepard; Stephen P Seslar |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-08-06 |
Journal Detail:
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Title: Pediatric cardiology Volume: 31 ISSN: 1432-1971 ISO Abbreviation: Pediatr Cardiol Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003849 Medline TA: Pediatr Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1016-24 Citation Subset: IM |
Affiliation:
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University of California, San Diego School of Medicine, La Jolla, CA, USA. brianlichtenstein@gmail.com |
Export Citation:
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Descriptor/Qualifier:
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| Grant Support | |
ID/Acronym/Agency:
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T32 RR023254/RR/NCRR NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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