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Korean J Thorac Cardiovasc Surg 2004; 37(6): 499-501

Published online June 5, 2004

Copyright © Journal of Chest Surgery.

Thirteen-year Experience of Permanent Epicardial Pacing in Children

Jeong Ryul Lee, M.D.*, Kook Nam Han, M.D.*, Hong Gook Lim*, Woong Han Kim, M.D.*Yong Jin Kim, M.D.*, Joon Ryang Rho, M.D.*, Eun Jung Bae, M.D.**Chung Il Noh, M.D.**, Yong Soo Yoon, M.D.**, Curie Ahn, M.D.***

Department of Thoracic, and Cardiovascular Surgery, Seoul National University, Children's Hospital, Seoul National University, College of Medicine, Department of Pediatrics, Seoul National University, Children's Hospital, Seoul National University, College of Medicine, Xenotransplantation Research Center, Clinical Research Institute, Seoul National University, Hospital

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: We investigated the longevity, thresholds of epicardial pacemaker and causes of reoperation in the pediatric patients who underwent epicardial pacemaker implantation performed during the last 13 years Material and Method: 121 operations were performed in 83 patients from January 1989 to July 2002. We analyzed the stimulation threshold, resistance, R-wave and P-wave, and sensitivity of pacemaker lead at initial implantation. Longevity and causes of reoperations were investigated. Result: At implantation, epicardial ventricular mean stimulation threshold was 1.2⁑0.1 (0.1∼5) mV, mean resistance was 519.1⁑18.1 (319∼778) Ohm, and mean R-wave sensitivity was 8.9⁑0.7 (4∼20) mV, and mean P wave sensivity was 2.5⁑0.7 (0.4∼12) mV. The mean longevity of pacemaker generator was 64.7⁑3.7 (2∼196) months. The reoperation free rate was 94.6% for 1 year, 93.6% for 2 years, 80.8% for 5years, 63.7% for 7 years, and 45.5% for 10 years. The causes of reoperation were battery waste in 26 cases and lead malfunction in 9 cases. There was no postoperative death related to pacemaker malfunction. Conclusion: In the childrens, average longevity of epicardial pacemaker was within acceptable range. 19.1% of the patients required pacemaker related reoperation. However, recent developments, including steroid eluting lead, 6.7% of the patients required pacemaker related reoperation, look promising in expansion of pacemaker life span. (Korean J Thorac Cardiovasc Surg 2004;37:499-503)

Keywords: 1. Pacemaker, artificial 2. Congenital heart defect

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Original

Korean J Thorac Cardiovasc Surg 2004; 37(6): 499-501

Published online June 5, 2004

Copyright © Journal of Chest Surgery.

Thirteen-year Experience of Permanent Epicardial Pacing in Children

Jeong Ryul Lee, M.D.*, Kook Nam Han, M.D.*, Hong Gook Lim*, Woong Han Kim, M.D.*Yong Jin Kim, M.D.*, Joon Ryang Rho, M.D.*, Eun Jung Bae, M.D.**Chung Il Noh, M.D.**, Yong Soo Yoon, M.D.**, Curie Ahn, M.D.***

Department of Thoracic, and Cardiovascular Surgery, Seoul National University, Children's Hospital, Seoul National University, College of Medicine, Department of Pediatrics, Seoul National University, Children's Hospital, Seoul National University, College of Medicine, Xenotransplantation Research Center, Clinical Research Institute, Seoul National University, Hospital

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: We investigated the longevity, thresholds of epicardial pacemaker and causes of reoperation in the pediatric patients who underwent epicardial pacemaker implantation performed during the last 13 years Material and Method: 121 operations were performed in 83 patients from January 1989 to July 2002. We analyzed the stimulation threshold, resistance, R-wave and P-wave, and sensitivity of pacemaker lead at initial implantation. Longevity and causes of reoperations were investigated. Result: At implantation, epicardial ventricular mean stimulation threshold was 1.2⁑0.1 (0.1∼5) mV, mean resistance was 519.1⁑18.1 (319∼778) Ohm, and mean R-wave sensitivity was 8.9⁑0.7 (4∼20) mV, and mean P wave sensivity was 2.5⁑0.7 (0.4∼12) mV. The mean longevity of pacemaker generator was 64.7⁑3.7 (2∼196) months. The reoperation free rate was 94.6% for 1 year, 93.6% for 2 years, 80.8% for 5years, 63.7% for 7 years, and 45.5% for 10 years. The causes of reoperation were battery waste in 26 cases and lead malfunction in 9 cases. There was no postoperative death related to pacemaker malfunction. Conclusion: In the childrens, average longevity of epicardial pacemaker was within acceptable range. 19.1% of the patients required pacemaker related reoperation. However, recent developments, including steroid eluting lead, 6.7% of the patients required pacemaker related reoperation, look promising in expansion of pacemaker life span. (Korean J Thorac Cardiovasc Surg 2004;37:499-503)

Keywords: 1. Pacemaker, artificial 2. Congenital heart defect

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