Key result
Epicardial pacing was associated with a threefold higher risk of pacemaker lead failure compared to endocardial pacing in pediatric patients (OR 3.00).
Why the study?
Pacing indications in children are defined, but whether epicardial or endocardial pacemakers perform better remains to be elucidated.
Does epicardial pacing compared to endocardial pacing increase lead-related complications in pediatric patients with atrioventricular block or sinus node dysfunction?
Meta-Analysis (n=1,348)
Does epicardial pacing compared to endocardial pacing increase lead-related complications in pediatric patients with atrioventricular block or sinus node dysfunction?
Odds Ratio: 3 (95% CI 2.05–4.39)
p-value: p=<0.001
In pediatric patients requiring pacing, epicardial pacemakers are associated with a threefold higher risk of lead failure compared to endocardial pacemakers, with no significant differences in other complications or mortality.
Authors
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Supports preferring endocardial pacing in children when feasible; strengthens Level 1 evidence on lead durability.
Patsiou et al. (2023) conducted a meta-analysis in Atrioventricular Block or Sinus Node Dysfunction (n=1,348). Epicardial pacing vs. Endocardial pacing was evaluated on Pacemaker lead failure (OR 3.00, 95% CI 2.05-4.39, p=<0.001). Epicardial pacing was associated with a threefold higher risk of pacemaker lead failure compared to endocardial pacing in pediatric patients (OR 3.00).
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