| VDD pacing in children with congenital complete heart block: advantages of a single pass lead. | |
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MedLine Citation:
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PMID: 9272518 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A single pass lead for VDD pacing in complete heart block is well described in adults but there are only brief reports of its use in children. We used standard adult size single pass leads in ten children and adolescents aged 3.7-17.2 years (mean 9.9 years) and weighing 13.5-76 kg (mean 35.4 kg) with congenital complete heart block. One patient had coexisting congenital heart disease and had undergone surgery. A 2:1 atrioventricular block in one patient was presumed to be congenital in origin. In four patients, the VDD system was their first pacing system. In six of the patients, 1-4 previous systems had been used and simultaneous extraction of ventricular leads (6) and/or atrial leads (2) was performed. Four different types of lead were used: Brilliant IMP15Q (Vitatron); Brilliant + IMR15Q (Vitatron); CapSure 5032 (Medtronic); and Unipass 425-13 (Intermedics) with four different generators: Saphir 600 (Vitatron); Saphir II 620 (Vitatron); Thera VDD 8948 (Medtronic); and Unity 292-07 (Intermedics). All leads were introduced via a subclavian vein puncture and the atrial dipole was placed low in the right atrium to provide slack for further growth while maintaining atrial sensing. Ventricular thresholds ranged from 0.2-0.8 V. The minimal atrial amplitude was 0.7-4 mV and the maximum amplitude was 2.5-8 mV. There was one early microdisplacement and the lead was repositioned. Over a follow-up period ranging from 1-39 months (mean 20.4 months), all patients have maintained low ventricular pacing thresholds and adequate atrial signals for reliable pacing at rest and with exercise. During this time some have undergone considerable growth. The patient with coexisting congenital heart disease died suddenly at 3 years, but the pacing system had no fault at autopsy. The standard adult size single pass lead provides a simple means to enable reliable atrial synchronous ventricular pacing in growing children with complete heart block. |
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Authors:
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E Rosenthal; J Bostock |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 20 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 1997 Aug |
Date Detail:
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Created Date: 1997-10-16 Completed Date: 1997-10-16 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2102-6 Citation Subset: IM |
Affiliation:
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Department of Pediatric Cardiology, Guy's Hospital, London, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Cardiac Pacing, Artificial* Child Child, Preschool Death, Sudden, Cardiac / etiology Electrocardiography Equipment Design Equipment Failure Female Follow-Up Studies Growth Heart Atria Heart Block / congenital*, therapy Heart Defects, Congenital / surgery Humans Male Microelectrodes Pacemaker, Artificial* Physical Exertion / physiology Punctures Reproducibility of Results Rest / physiology Retreatment Subclavian Vein Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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