Physiological pacing in young patients with complex congenital heart defects

Silvetti, Massimo Stefano; Pazzano, Vincenzo; Battipaglia, Irma; Mambro, Corrado Di; Calvieri, Camilla; Saputo, Fabio Anselmo; Verticelli, Letizia; Carotti, Adriano; Torcinaro, Sergio; Drago, Fabrizio

doi:10.1111/pace.13409

Cited by 2 publications

(3 citation statements)

References 15 publications

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“…In SND, atrial pacing is better than ventricular pacing. Rate-responsive sensors will produce more physiologic stimulation [27,28]. In the PACES Statement, atrial or dualchamber PM is recommended.…”

Section: Sinus Node Dysfunction (Snd)mentioning

confidence: 99%

“…Class II a recommendations refer to antitachycardia pacing in CHD patients with recurrent intra-atrial reentrant tachycardia in whom ablation or medications were ineffective or not acceptable treatment [36,37]; atrial or dual-chamber pacing in patients with complex CHD and with impaired hemodynamic caused by sinus bradycardia or loss of AV synchrony as in single-ventricle physiology [28,38]. Class II recommendations apply to patients with SND, CHD and mean awake resting HR < 40 bpm and/or prolonged pauses: COR II a in the presence of a complex CHD; COR II b in the presence of a moderate CHD [23].…”

Section: Chdmentioning

confidence: 99%

See 1 more Smart Citation

New Guidelines of Pediatric Cardiac Implantable Electronic Devices: What Is Changing in Clinical Practice?

Silvetti,

Colonna,

Gabbarini

et al. 2024

JCDD

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Guidelines are important tools to guide the diagnosis and treatment of patients to improve the decision-making process of health professionals. They are periodically updated according to new evidence. Four new Guidelines in 2021, 2022 and 2023 referred to pediatric pacing and defibrillation. There are some relevant changes in permanent pacing. In patients with atrioventricular block, the heart rate limit in which pacemaker implantation is recommended was decreased to reduce too-early device implantation. However, it was underlined that the heart rate criterion is not absolute, as signs or symptoms of hemodynamically not tolerated bradycardia may even occur at higher rates. In sinus node dysfunction, symptomatic bradycardia is the most relevant recommendation for pacing. Physiological pacing is increasingly used and recommended when the amount of ventricular pacing is presumed to be high. New recommendations suggest that loop recorders may guide the management of inherited arrhythmia syndromes and may be useful for severe but not frequent palpitations. Regarding defibrillator implantation, the main changes are in primary prevention recommendations. In hypertrophic cardiomyopathy, pediatric risk calculators have been included in the Guidelines. In dilated cardiomyopathy, due to the rarity of sudden cardiac death in pediatric age, low ejection fraction criteria were demoted to class II. In long QT syndrome, new criteria included severely prolonged QTc with different limits according to genotype, and some specific mutations. In arrhythmogenic cardiomyopathy, hemodynamically tolerated ventricular tachycardia and arrhythmic syncope were downgraded to class II recommendation. In conclusion, these new Guidelines aim to assess all aspects of cardiac implantable electronic devices and improve treatment strategies.

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Section: Sinus Node Dysfunction (Snd)mentioning

confidence: 99%

Section: Chdmentioning

confidence: 99%

New Guidelines of Pediatric Cardiac Implantable Electronic Devices: What Is Changing in Clinical Practice?

Silvetti,

Colonna,

Gabbarini

et al. 2024

JCDD

Self Cite

View full text Add to dashboard Cite

show abstract

“…Careful programming of pacemaker systems in regard of timing intervals is crucial as many pitfalls may arise (eg, Pacemaker mediated tachycardia, impaired ventricular function, and left ventricular filling, 2:1 block response). Recently Silvetti et al 6 have shown that atrial CLS pacing using transvenous as well as epicardial leads is effective in young patients with operated complex congenital heart defects (CHD). Atrial CLS pacing should be considered an alternative.…”

Section: Commentarymentioning

confidence: 99%

Atrial auto‐short phenomenon as a rare cause of ventricular lead failure in a pediatric dual chamber pacemaker patient

Noessler

Köestenberger

Kurath‐Koller

2020

Pacing Clinical Electrophis

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Physiological pacing in young patients with complex congenital heart defects

Abstract: In young CHD patients, endocardial/epicardial CLS-atrial pacing demonstrated a physiological response of heart rate to neurovegetative and physical stresses.

Cited by 2 publications

References 15 publications

New Guidelines of Pediatric Cardiac Implantable Electronic Devices: What Is Changing in Clinical Practice?

New Guidelines of Pediatric Cardiac Implantable Electronic Devices: What Is Changing in Clinical Practice?

Atrial auto‐short phenomenon as a rare cause of ventricular lead failure in a pediatric dual chamber pacemaker patient

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