Marcapasso endocárdico definitivo na primeira década de vida

Costa, Roberto; Barbosa, Luiz Carlos V; Moreira, Luíz Felipe Pinho; Filho, Martino Martinelli; Pêgo‐Fernandes, Paulo Manuel; Stolf, Noedir A. G; G, Verginelli; Jatene, Adib

doi:10.1590/s0102-76381986000200004

Cited by 2 publications

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“…Third, failure to truly understand the details of device malfunction in the reused pacemaker group is a significant limitation of this meta-analysis. Complications such as set screw malfunction (nϭ3), 8,26 premature battery depletion (nϭ1), 26 electromagnetic inhibition (nϭ1), 27 spontaneous reprogramming (nϭ1), 27 and pectoral muscle inhibi- 6 that resolved on device extraction may be secondary to lead placement rather than device malfunction. The fourth limitation of our study is the lack of available data regarding implanter experience and a possible association with complications.…”

Section: Limitationsmentioning

confidence: 99%

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Safety of Pacemaker Reuse

Baman

Meier

Romero

et al. 2011

Circ: Arrhythmia and Electrophysiology

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Background— A large disparity in medical health care is clearly evident between developed and underserved nations in the field of cardiac electrophysiology, specifically pacemaker implantation. This study aimed to assess the safety of pacemaker reuse. Methods and Results— A computerized search from January 1, 1970, to September 1, 2010, identified 18 studies with outcomes of pacemaker reuse. The primary outcome was pacemaker infection or device erosion as defined by each individual study protocol. Secondary end points were device malfunction defined as a defect in the structural or electric integrity of the pulse generator. Pooled individual patient data (n=2270) from 18 trials were included in the analysis. The proportion of patients in whom an infection developed after pacemaker reuse was 1.97% (1.15% to 3.00%). There was no significant difference in infection rate between pacemaker reuse and new device implantation (odds ratio, 1.31 [0.50 to 3.40], P =0.580). The proportion of patients in whom device malfunction developed after pacemaker reuse was 0.68% (0.27% to 1.28%). Compared with new device implantation, there was an increased risk for malfunction in the reuse group (odds ratio, 5.80 [1.93 to 17.47], P =0.002). This difference was mainly driven by abnormalities in set screws, which possibly occurred during device extraction, as well as nonspecific device “technical errors.” Conclusions— This study suggests that pacemaker reuse has an overall low rate of infection and device malfunction and may be a safe and efficacious means of treating patients in underserved nations with symptomatic bradyarrhythmias and no other method of obtaining a device. However, the results also denote a higher rate of device malfunction as compared with new device implantation. Patients with highly symptomatic conduction disease may benefit from pacemaker reuse; however, they should be closely monitored for device malfunction, especially during implantation.

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Section: Limitationsmentioning

confidence: 99%

“…Copperman 29 Costa 24 Amikam 31 Sedney 25 Havia 32 Mond 30 Balachander 26 Rosengarten 28 Pescariu 7 Linde 6 Panja 27 Grendahl 5 Namboodiri 35 Baman 21 Grendahl 5 Rosengarten 8 Panja 27 Pescariu 7…”

Section: Meta-analysismentioning

confidence: 99%

Safety of Pacemaker Reuse

Baman

Meier

Romero

et al. 2011

Circ: Arrhythmia and Electrophysiology

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“…Pulse generators were implanted in the supra-inguinal area in subcutaneous or subaponeurotic positions on the left side in 91.9% of the cases and on the right side in 8.9%. The implantation technique has previously been described by Costa et al [6,7].…”

Section: Implantation Techniquementioning

confidence: 99%

“…However, lower rates of complications have been reported with endocardial electrodes. The transvenous access via the femoral vein was proposed for pediatric patients of all age ranges from newborns to teenagers, with good pacing performance and sensitivity over the longterm [6,7].…”

Section: Introductionmentioning

confidence: 99%

Análise dos fatores de risco para mortalidade na estimulação pediátrica endocárdica transfemoral: experiência em longo prazo

Costa¹,

Filho²,

Tamaki³

et al. 2005

Rev Bras Cir Cardiovasc

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Objective: Permanent cardiac pacing improves survival of children with congenital or acquired bradycardia, although mortality after pacing remains relatively high. The aim of this study was to evaluate the long-term outcomes of children who undergo permanent endocardial pacing via the femoral vein, including the identification of associated risk factors for mortality.Method: From 1981 to 2000, 99 patients ranging in ages from one day to 13 years (4.1 ± ± ± ± ± 3.6 and median = 3 years) underwent permanent transfemoral pacemaker implantation due to congenital (39.4%), post-surgical (54.5%), or nonsurgically acquired bradycardia (6.1%).Results: By the end of 7.1 ± 5.3 years (708.3 patient-years) of prospective follow-up, 18 (18.2%) patients had died. The actuarial survival rates were 85%, 79.5%, and 74.2%, at 5, 10, and 15 years, respectively. Independent predictors of mortality identified by Cox proportional hazards analysis were younger age at implantation (p = 0.028), the presence of untreated cardiac anomalies or intracardiac prostheses (p = 0.0001), and radiographic evidence of cardiomegaly (p = 0.035). Conclusions: Permanent endocardial pacing via the femoral vein presented survival expectance comparable to other techniques with a low rate of pacing complications. Long-term survival was limited by lower ages and cardiac dilatation at the time of implantation as well as by the presence of untreated cardiac defects or valve prostheses.Descriptors: Cardiac pacing, artificial. Pediatrics. Heart block, mortality. Risk factors. Análise dos fatores de risco para mortalidade na estimulação pediátrica endocárdica transfemoral: experiência em longo prazoRisk factors analysis in transvenous pediatric pacing through femoral access: long-term experience 124 COSTA, R ET AL -Risk factors analysis in transvenous pediatric pacing through femoral access: long-term experience Braz J Cardiovasc Surg 2005; 20(2): 123-128

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Marcapasso endocárdico definitivo na primeira década de vida

Cited by 2 publications

References 0 publications

Safety of Pacemaker Reuse

Safety of Pacemaker Reuse

Análise dos fatores de risco para mortalidade na estimulação pediátrica endocárdica transfemoral: experiência em longo prazo

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