Document Detail


VDD pacing in children with congenital complete heart block: advantages of a single pass lead.
MedLine Citation:
PMID:  9272518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
E Rosenthal; J Bostock
Related Documents :
24447968 - Effects of distance and duration on vertical dynamic visual acuity in screening healthy...
16006698 - Routine chest radiography after permanent pacemaker implantation: is it necessary?
18515048 - Evaluation of time memory in acutely depressed patients, manic patients, and healthy co...
17526508 - Tachycardia after pacemaker implantation in a patient with complete atrioventricular bl...
10799178 - The pathophysiology of post-radical prostatectomy incontinence: a clinical and video ur...
3335558 - Deep-vein thrombosis and continuous passive motion after total knee arthroplasty.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  20     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1997 Aug 
Date Detail:
Created Date:  1997-10-16     Completed Date:  1997-10-16     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2102-6     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiology, Guy's Hospital, London, United Kingdom.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  Natural history of congenital complete atrioventricular block.
Next Document:  Electrophysiology of "incisional" reentrant atrial tachycardia complicating surgery for congenital h...