Key result
Epicardial Medtronic 3830 lead lowers pacing thresholds to ~1.1 V after failed conventional leads.
Why the study?
Conventional epicardial leads in pediatric patients often fail due to high thresholds, fractures, or poor sensing after multiple surgeries.
Case Report (n=1)
Epicardial use of the Medtronic SelectSecure 3830 lead represents a feasible alternative for achieving stable pacing thresholds in complex pediatric redo procedures when conventional leads fail.
May offer alternative for high-threshold epicardial pacing in pediatric redo cases; hypothesis-generating and requires prospective validation.
BACKGROUND: Epicardial pacing is standard in children, but conventional leads often fail due to high thresholds, fractures, or poor sensing after multiple surgeries. CASE: A 10-year-old with restrictive cardiomyopathy and prior mitral valve replacement presented with loss of capture from fractured epicardial leads. Redo sternotomy attempts with conventional leads produced thresholds up to 8.0 V. A Medtronic SelectSecure 3830 lead was implanted epicardially, achieving improved thresholds (2.7 V → 1.1 V) and stable cardiac resynchronization therapy (CRT) pacemaker function. At 2 months, thresholds and impedances remained low and stable. CONCLUSION: Epicardial Medtronic SelectSecure 3830 lead implantation may be a feasible alternative in complex pediatric redo cases.
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Altın et al. (2026) conducted a case report in Restrictive cardiomyopathy with fractured epicardial leads (n=1). Epicardial Medtronic SelectSecure 3830 lead vs. Conventional epicardial leads was evaluated on Pacing thresholds. Epicardial implantation of a Medtronic 3830 lead achieved improved pacing thresholds (to 1.1 V) at 2 months in a pediatric case where redo sternotomy with conventional leads yielded up to 8.0 V.
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