Abstract
Corresponding author
[email protected] ( Hosny Hosny Elsayed Arafa)
Background
Permanent Pacemakers have a growing use in the pediatric population due to congenital and surgically acquired rhythm disturbances but they present unique problems and implications. Their implantation, follow up, the diversity and complexity of pediatric patients and congenital heart disease make device management a highly individualized art in pediatric pacing. Certain challenges are posed in adult-like somatic growth and active lifestyle susceptibility to infection and generally anticipated long survival.
Objective
The current study aims to present our institute's experience in pediatric and adolescent pacemaker implantation and long term outcome.
Patients and Methods
The study included 100 patients who have cardiac devices (permanent pacemaker)that were implanted in AinShams University and visit our patient clinic for regular programming during the period from July 2018 to December 2019. All patients were subjected to history taking, clinical examination, ECG recording then Echocardiography and device programming.
Results
The study included 100 patients,49 females and 51 males with a mean age of 13.12 ± 5.04. Patients weighted from 8 to 85 kg, measured from 40 to 185 cm in height. According to the mode of pacing, 67 were in the VVIR group while 33 in the DDDR group. According to the indication of pacing, two cases were due to sinus node dysfunction,52 due to congenital complete heart block and 46 due to postoperative CHB. 59 patients underwent cardiac surgery. 53 were admitted to CCU by syncope or presyncope. As Regards the complications,2 cases had superficial infection after 2 weeks relived by antibiotic, 2 patients suffered from pocket hematoma after 2 weeks, 10 cases of lead fracture from 1 to 8 years after implantation due to external trauma, 3 cases of lead dislodgment from 1 to 6 months postprocedure,1 case developed LV dysfunction and upgraded to CRT,1 case had psychological trauma and 3 cases had insulation breaks. The device with the longest longevity duration is Medtronic and Tendril leads had the most common complications.
Conclusion
Implantation of a pacemaker in children is generally safe. It could be justified to implant the pacemaker to improve the hemodynamic situation in individual patients or to consider biventricular pacing in LV dysfunctiont