Key result
Contemporary conduction site-specific pacing, such as His-bundle and left bundle branch pacing, offers potential physiologic benefits over historical right ventricular apical pacing for children.
Why the study?
This review was conducted to explore the historical events leading to modern pacemakers and examine how contemporary conduction site-specific pacing addresses the deleterious effects of chronic right ventricular apical pacing.
The review emphasizes the need for proactive consideration of short and long-term pacing solutions, such as conduction system pacing, for pediatric patients who will require lifelong pacing.
May support conduction system pacing in children needing lifelong therapy; leaves open need for pediatric RCTs to confirm outcomes.
PURPOSE OF REVIEW: The purpose of this review is to explore the historical and serendipitous events that led to the creation of modern-day pacemakers. In addition, this review will explore how contemporary conduction site-specific pacing has overcome some of the deleterious effects from historical chronic right ventricular apical pacing. RECENT FINDINGS: Recently, there have been tremendous advances in not just the lead design but the tools required to promote more physiologic pacing. Although cardiac resynchronization pacing has been around for nearly 2 decades, this review also introduces and discusses the early results of His-bundle pacing and left bundle branch pacing and some of the potential applicability of this technology for our children. SUMMARY: Pacemakers have evolved significantly in the last 30 years through collaborative partnerships between physicians and engineers. The future of cardiac pacing is bright compared to the field of electrotherapy 50 years ago. Future iterations of pacemakers must consider unusual anatomy and growing children. Pediatric patients contribute to a small percentage of the overall device volume, but the majority of these patients will have a pacemaker for life. We need to be proactive and consider what are the best short and long-term solutions for this cohort.
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Cohen et al. (2022) conducted a review in Cardiac pacing in pediatric patients. Cardiac pacing was evaluated. Contemporary conduction site-specific pacing, such as His-bundle and left bundle branch pacing, offers potential physiologic benefits over historical right ventricular apical pacing for children.
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