A 12-Year Experience of Bipolar Steroid-Eluting Epicardial Pacing Leads in Children

Tomaske, Maren; Gerritse, Bart; Kretzers, L. M. J.; Prêtre, René; Dodge‐Khatami, Ali; Rahn, Mariette; Bauersfeld, Urs

doi:10.1016/j.athoracsur.2008.02.016

Cited by 76 publications

(73 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, in the presence of (relative) contraindications for the transvenous approach, such as small body size, an intra-cardiac shunt or absence of a venous access, an epicardial lead implantation is preferred despite the high rate of lead failure. The estimations of lead longevity vary widely, and seems to be difficult to predict whereas different risk factors for lead failure had been described [3][4][5][6][7][8][9][10]. In our study, we found an incidence of lead failure of 2.3% per lead per year of follow-up.…”

Section: Discussionsupporting

confidence: 53%

Failure of epicardial pacing leads in congenital heart disease: not uncommon and difficult to predict

Post

Budts²,

Bruaene³

et al. 2011

Neth Heart J

View full text Add to dashboard Cite

Aims We evaluate the incidence of epicardial lead failure and try to identify risk factors in patients with congenital heart disease. Methods All patients with a congenital heart defect and an epicardial pacing system, implanted within a timeframe of 25 years, were included in this study. Patients' medical records and lead data were reviewed. Lead failure was defined as the primary endpoint. Results In total 198 active epicardial leads (atrial 40, ventricular 158) were implanted in 93 patients (median age at implantation 4.4 years (range 0-58.6)). During a total follow-up of 1235 lead-years, 29 lead failures (14.6%, 4 atrial, 25 ventricular) were documented in 22 patients (23.7%). Lead failure occurred at a median time period of 4.8 years (range 1.2-24.1) after implantation. Five-year freedom of lead failure was 88%. The only independent predictor for lead failure was the age at implantation (HR 0.44;

show abstract

Section: Discussionsupporting

confidence: 53%

Failure of epicardial pacing leads in congenital heart disease: not uncommon and difficult to predict

Post

Budts²,

Bruaene³

et al. 2011

Neth Heart J

View full text Add to dashboard Cite

show abstract

“…The combination of atrial arrhythmias and underlying sinus and/or junctional bradycardia makes therapy with antiarrhythmic medications extremely challenging. Surgeons should plan for this eventuality by placing steroid-eluting epicardial leads at the time of the Fontan repair [39].…”

mentioning

confidence: 99%

Fontan “Ten Commandments” Revisited and Revised

Stern

2010

Pediatr Cardiol

View full text Add to dashboard Cite

Choussat's ''Ten Commandments,'' which describes the components of an ideal Fontan candidate, was first published in 1977. Despite the wisdom in these commandments, it is clear from a historic perspective that total compliance with all criteria does not necessarily portend excellent long-term survival. I believe the end point of the original commandments should be modified to include improvement in long-term survival. I suggest the following single commandment: ''Thou Shalt Be Perfect.''

show abstract

“…The 5-year lead survival was 83% for steroid-eluting leads. Tomaske et al 20 showed excellent sensing and pacing thresholds with bipolar steroid-eluting epicardial leads in children (<18.5 years) followed up to 12 years with ventricular lead survival of 85% at 5 years. Paech et al 21 recently reported a single-center experience of 158 steroid-eluting bipolar epicardial leads in 82 children and adults with congenital heart disease-median follow-up of 3.3 years.…”

Section: Discussionmentioning

confidence: 99%

“…The 5-year lead survival is similar to transvenous pacing in older children, and similar or better than epicardial steroid-eluting leads in older children. [19][20][21][22] Thus, lead survival even in small children-a challenging setting with a rapidly growing child-is encouraging. At a median 14.3 years of pacing, 7 patients continued with their original leads, suggesting that the atrial loop at the initial implant allowed somatic growth and contributed to the long pacing lead survival.…”

Section: Discussionmentioning

confidence: 99%

Twenty-Seven Years Experience With Transvenous Pacemaker Implantation in Children Weighing <10 kg

Konta

Chubb

Bostock

et al. 2016

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

Original ArticleBackground-Epicardial pacemaker implantation is the favored approach in children weighing <10 kg in many units. The high incidence of premature failure and fractures with earlier epicardial leads led our unit to undertake transvenous pacemaker implantation in neonates and infants from 1987. To date there have been no long-term follow-up reports of what is for many a controversial strategy. Methods and Results-Between 1987 and 2003, 37 neonates and infants-median age 6.7 months (1 day to 3 years) and median weight 4.6 kg (2.7-10 kg)-had a permanent transvenous pacing system implanted. Pacing leads were placed into the right ventricular apex/outflow tract through a subclavian vein puncture with a redundant loop in the atrium. Three patients were lost to follow-up, 4 patients died from complications of cardiac surgery, and 2 patients had their system removed. At long-term follow-up in 28 patients at a median of 17.2 (range, 11.2-27.4) years, 10 patients have a single chamber ventricular pacemaker, 14 a dual chamber pacemaker, 3 a biventricular pacemaker, and 1 has a single chamber implantable cardioverter defibrillator. Subclavian vein patency was assessed in 26 patients. The overall subclavian vein occlusion rate was 10 of 13 (77%) <5 kg and 2 of 13 (15%) >5 kg during long-term follow-up. After a median of 14.3 (range, 13.4-17.6) years of pacing, 7 patients continue with their original lead. Conclusions-Transvenous pacing in infants <10 kg results in encouraging short-and long-term clinical outcomes.Subclavian vein occlusion remains an important complication, occurring predominantly in those weighing <5 kg.(Circ Arrhythm Electrophysiol. 2016;9:e003422.

show abstract

A 12-Year Experience of Bipolar Steroid-Eluting Epicardial Pacing Leads in Children

Cited by 76 publications

References 25 publications

Failure of epicardial pacing leads in congenital heart disease: not uncommon and difficult to predict

Failure of epicardial pacing leads in congenital heart disease: not uncommon and difficult to predict

Fontan “Ten Commandments” Revisited and Revised

Twenty-Seven Years Experience With Transvenous Pacemaker Implantation in Children Weighing <10 kg

Contact Info

Product

Resources

About