Key result
Pediatric permanent pacing yields low lead complications, with only ~8% experiencing electrode problems mid-term.
Why the study?
With improved pacemaker technology, longer survival after complex repairs, and better monitoring techniques, the indications for cardiac pacing in children have broadened.
Observational (n=50)
Sinus node dysfunction has become the predominant indication for permanent pacemaker implantation in children, largely following complex cardiac repairs.
Low electrode failure supports pediatric pacing feasibility; leaves open long-term generator durability and need for prospective data.
Permanent pacemakers were implanted in 50 children. Indications were symptomatic sinus node dysfunction in 34 (68%), surgical block in 9 (18%), and congenital block in 7 (14%). Twenty-three (68%) of the 34 children with sinus node dysfunction had undergone prior cardiac operations. Only 4 of the 50 patients (8%) had electrode problems after a mean pacing time of 29.5 months (range, 1 to 96 months). All 35 of the mercury-cell pulse generators used in 28 patients ceased to function after an average useful life of 20.8 months (range, 1 to 51 months). The lithium-powered units in the 45 survivors all show satisfactory pacing after 5 to 44 months (mean, 28.1 months). With improved pacemaker technology, longer survival after complex repairs, and better monitoring techniques, the indications for cardiac pacing in children have broadened. Surgical block now is an indication in only a small fraction of the pediatric pacemaker population. Sinus node dysfunction accounts for an ever-increasing majority of the pacemakers we currently implant in children.
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Fleming et al. (1981) conducted an observational in Indications for pacemakers in children (n=50). Permanent pacemaker implantation was evaluated on Indications for pacing and device performance. Permanent pacemaker implantation in 50 children was primarily indicated for symptomatic sinus node dysfunction (68%), with only 8% experiencing electrode problems over a mean 29.5 months.
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