Age, Size, and Lead Factors Alone Do Not Predict Venous Obstruction in Children and Young Adults with Transvenous Lead Systems

Abstract

Transvenous lead systems implanted in young children have a similar incidence of venous occlusion compared to older patients. Furthermore, patient age, body size, and lead characteristics at implant do not clearly predict venous occlusion.

Cardiac pacing in infants and children

“…w19 Another important problem with endocardial leads is venous stenosis or occlusion. An incidence of 13% partial venous occlusion and 12% complete venous occlusion has been reported in children after a median of 6.5 years of pacing 10. Usually venous stenosis is asymptomatic but can present with venous congestion and swelling of the ipsilateral arm.…”

Pacemakers and Other Cardiac Implantable Devices in Children

“…3 Konta et al 2 recognize that their practice is unusual and that the high rate of venous occlusion in small children after endocardial lead placement has lead a majority of pediatric electrophysiologists to favor epicardial pacing and defibrillation leads for patients weighing <10 to 15 kg. [4][5][6][7][8] That said, the outcomes of endocardial pacing system placement reported by Konta et al 2 are unusually favorable for patients weighing >5 to <10 kg when compared with prior studies, documenting a low 8% incidence of subclavian vein occlusion in 13 patients at a median of 9.2 years (range, 3 months to 12.9 years). The incidence of subclavian vein occlusion reported by Konta et al 2 for patients weighing <5 kg is closer to prior publications at 70% in 13 patients at a median of 9.2 years (range, 3 months to 12.9 years).…”

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

“…They were unable to implicate age, size, growth, or lead factors in this older population. 28 We found that SCV occlusion after multiple procedures during long-term follow-up was more frequent in those weighing <5 kg at the time of the pacemaker implantation-10 of 13 (77%) <5 kg and 2 of 13 (15%) >5 kg. The rate of SCV occlusion in those weighing 5 to 10 kg was similar to that in considerably older patients.…”

“…Bar-Cohen et al 28 performed contrast venography in 85 children and young adults (median age, 15 years at implant) before a repeat pacemaker/implantable cardioverter defibrillator procedure. There was a 13% SCV occlusion at a median interval of 6.5 years.…”