Long-term follow-up after pacemaker implantation in neonates and infants
Standard
Long-term follow-up after pacemaker implantation in neonates and infants. / Aellig, Natalie C; Balmer, Christian; Dodge-Khatami, Ali; Rahn, Mariette; Prêtre, René; Bauersfeld, Urs.
In: ANN THORAC SURG, Vol. 83, No. 4, 04.2007, p. 1420-1423.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Long-term follow-up after pacemaker implantation in neonates and infants
AU - Aellig, Natalie C
AU - Balmer, Christian
AU - Dodge-Khatami, Ali
AU - Rahn, Mariette
AU - Prêtre, René
AU - Bauersfeld, Urs
PY - 2007/4
Y1 - 2007/4
N2 - BACKGROUND: Pacemaker (PM) system implantation in neonates and infants is often complicated by hemodynamic instability, small vessel size, and abnormal cardiovascular anatomy. Thus, an open surgical approach for epicardial lead insertion is often required. We assessed the long-term outcomes after epicardial PM implantation in this age group.METHODS: Between 1992 and 2004, 22 consecutive patients underwent PM implantation within the first year of life. Bipolar steroid-eluting epicardial leads (Medtronic CapSure Epi 10366 and 4968) were inserted through median sternotomy, the sybxyphoid approach, or thoracotomy, and connected to various pulse generators.RESULTS: Pacemakers were implanted at a median age of 35 days (range, 1 to 300). Intracardiac anatomy was abnormal in 17 patients. Indications for PM therapy were heart block in 18 patients and sinus node dysfunction in 4 patients. During a median follow-up of 4.6 years (range, 4 days to 12.8 years), 7 devices were replaced owing to end of battery life (n = 6) or elective device repositioning (n = 1), at a median of 4.1 years (range, 1 to 7.8). One dislodged ventricular lead and 2 atrial lead sensing failures were observed. Sensing, pacing thresholds, and lead impedances showed good implant and stable follow-up values.CONCLUSIONS: Pacemaker-associated morbidity is low. Pacemaker system complications with epicardial leads are rare. Battery life is relatively shorter compared with children and adults because of the fast heart rate and complete PM dependency in most of these children. Even for neonates and infants, modern pacemaker therapy is feasible, safe, and effective.
AB - BACKGROUND: Pacemaker (PM) system implantation in neonates and infants is often complicated by hemodynamic instability, small vessel size, and abnormal cardiovascular anatomy. Thus, an open surgical approach for epicardial lead insertion is often required. We assessed the long-term outcomes after epicardial PM implantation in this age group.METHODS: Between 1992 and 2004, 22 consecutive patients underwent PM implantation within the first year of life. Bipolar steroid-eluting epicardial leads (Medtronic CapSure Epi 10366 and 4968) were inserted through median sternotomy, the sybxyphoid approach, or thoracotomy, and connected to various pulse generators.RESULTS: Pacemakers were implanted at a median age of 35 days (range, 1 to 300). Intracardiac anatomy was abnormal in 17 patients. Indications for PM therapy were heart block in 18 patients and sinus node dysfunction in 4 patients. During a median follow-up of 4.6 years (range, 4 days to 12.8 years), 7 devices were replaced owing to end of battery life (n = 6) or elective device repositioning (n = 1), at a median of 4.1 years (range, 1 to 7.8). One dislodged ventricular lead and 2 atrial lead sensing failures were observed. Sensing, pacing thresholds, and lead impedances showed good implant and stable follow-up values.CONCLUSIONS: Pacemaker-associated morbidity is low. Pacemaker system complications with epicardial leads are rare. Battery life is relatively shorter compared with children and adults because of the fast heart rate and complete PM dependency in most of these children. Even for neonates and infants, modern pacemaker therapy is feasible, safe, and effective.
KW - Age Factors
KW - Bradycardia/congenital
KW - Cardiac Pacing, Artificial/methods
KW - Cohort Studies
KW - Confidence Intervals
KW - Female
KW - Follow-Up Studies
KW - Heart Block/congenital
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Male
KW - Pacemaker, Artificial
KW - Probability
KW - Prosthesis Implantation
KW - Retrospective Studies
KW - Risk Assessment
KW - Survival Analysis
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1016/j.athoracsur.2006.11.042
DO - 10.1016/j.athoracsur.2006.11.042
M3 - SCORING: Journal article
C2 - 17383349
VL - 83
SP - 1420
EP - 1423
JO - ANN THORAC SURG
JF - ANN THORAC SURG
SN - 0003-4975
IS - 4
ER -