A lead cross-sectional area indexed to body surface area > 6.6 mm2/m2 predicted venous obstruction in children with transvenous pacing leads with 90% sensitivity and 84% specificity (P<0.0002).
Observational (n=63)
What are the risk factors for venous obstruction in children with transvenous pacing leads?
In children with transvenous pacing leads, a lead cross-sectional area indexed to body surface area > 6.6 mm2/m2 is a strong predictor of venous obstruction, highlighting the importance of appropriate lead sizing.
p-value: p=<0.0002
To determine the incidence and risk factors for venous obstruction in children with transvenous pacing leads, 63 children were evaluated clinically and echocardiographically. Patients with abnormal clinical and/or echocardiographic findings were further investigated by venography. Thirteen patients (21%) had evidence of venous obstruction. Venography in 11 (2 refused) showed that severity of obstruction (as defined by percentage of luminal narrowing) was complete (100%) in 3, severe (> 90%) in 4, and moderate (60%-90%) in 5 (1 patient having 2 sites of obstruction). Risk factors for obstruction in 55 patients with single implantation procedures (10 with obstruction; 18%) were sought. Total cross-sectional area of lead(s) was indexed to body surface area at implantation (INDEX). Patients with obstruction had a higher mean INDEX (7.6 +/- 1.6 mm2/m2) than patients without obstruction (4.9 +/- 2.0 mm2/m2); P 6.6 mm2/m2 to best predict obstruction, with a sensitivity of 90% and specificity of 84%. Since pacing is lifelong, sizing of transvenous leads to the child is important to prevent obstruction and preserve venous access.
Figa et al. (Fri,) conducted a observational in Children with transvenous pacing leads (n=63). Total cross-sectional area of lead(s) indexed to body surface area (INDEX) vs. Lower INDEX was evaluated on Venous obstruction (p=<0.0002). A lead cross-sectional area indexed to body surface area > 6.6 mm2/m2 predicted venous obstruction in children with transvenous pacing leads with 90% sensitivity and 84% specificity (P<0.0002).