Long-term experience with AutoCapture-controlled epicardial pacing in children

TY - JOUR

T1 - Long-term experience with AutoCapture-controlled epicardial pacing in children

AU - Tomaske, Maren

AU - Harpes, Paul

AU - Pretre, Rene

AU - Dodge-Khatami, Ali

AU - Bauersfeld, Urs

PY - 2007/8

Y1 - 2007/8

N2 - AIMS: To examine the feasibility and safety of AutoCapture (AC)-controlled pacing with epicardial leads in children, and study the effects on device longevity.METHODS: A total of 62 children were prospectively enrolled. Pre-discharge testing precluded AC function in six children. In 56 (90%) children, devices with AC-controlled pacing were followed up to 9years. Calculated battery life in AC-controlled pacing was compared with theoretical calculations, using a two-fold stimulation output of measured thresholds.RESULTS: In 53 of 56 children, no differences were observed for evoked response signals (13.3 vs. 11.5mV, P = 0.20) or lead polarization safety margins (5.5 vs. 4.1, P = 0.25) at 6-month and 4-year follow-up. A crossover to conventional pacing was required in 3 of 56 children. AC-controlled pacing prolonged the calculated battery life up to 15% for the identity and integrity devices with 0.95A h capacity, compared with theoretical conventional settings (P = 0.008). In patients with ventricular pacing thresholds >1.5V at 0.5ms, battery life was increased by 30% compared with theoretical conventional settings (P < 0.001).CONCLUSION: AC-controlled pacing with epicardial leads is feasible and safe in children during long-term follow-up. An adequate lead polarization safety margin persists in most patients. Calculated battery life was prolonged up to 15% with AC-controlled pacing. Patients with high or fluctuating pacing thresholds benefit the most.

AB - AIMS: To examine the feasibility and safety of AutoCapture (AC)-controlled pacing with epicardial leads in children, and study the effects on device longevity.METHODS: A total of 62 children were prospectively enrolled. Pre-discharge testing precluded AC function in six children. In 56 (90%) children, devices with AC-controlled pacing were followed up to 9years. Calculated battery life in AC-controlled pacing was compared with theoretical calculations, using a two-fold stimulation output of measured thresholds.RESULTS: In 53 of 56 children, no differences were observed for evoked response signals (13.3 vs. 11.5mV, P = 0.20) or lead polarization safety margins (5.5 vs. 4.1, P = 0.25) at 6-month and 4-year follow-up. A crossover to conventional pacing was required in 3 of 56 children. AC-controlled pacing prolonged the calculated battery life up to 15% for the identity and integrity devices with 0.95A h capacity, compared with theoretical conventional settings (P = 0.008). In patients with ventricular pacing thresholds >1.5V at 0.5ms, battery life was increased by 30% compared with theoretical conventional settings (P < 0.001).CONCLUSION: AC-controlled pacing with epicardial leads is feasible and safe in children during long-term follow-up. An adequate lead polarization safety margin persists in most patients. Calculated battery life was prolonged up to 15% with AC-controlled pacing. Patients with high or fluctuating pacing thresholds benefit the most.

KW - Cardiac Pacing, Artificial/methods

KW - Child

KW - Electrocardiography/instrumentation

KW - Equipment Design

KW - Equipment Failure Analysis

KW - Female

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Pacemaker, Artificial

KW - Pericardium

KW - Therapy, Computer-Assisted/instrumentation

KW - Treatment Outcome

U2 - 10.1093/europace/eum130

DO - 10.1093/europace/eum130

M3 - SCORING: Journal article

C2 - 17630391

VL - 9

SP - 645

EP - 650

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 8

ER -