Implantation of permanent cardiac pacemakers in infants and young children in the lumbar position

Hafez, Abdullah; Binet, J P

doi:10.1007/bf02306754

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“…The site of implantation of the pulse generator remains controversial. Several choices have been proposed, including the preperitoneal, perirenal, pleural and suprahepatic spaces 7–13 . The inferior abdominal wall, used in this report, allowed to implant pulse generators in neonates.…”

Section: Discussionmentioning

confidence: 99%

Transfemoral Pediatric Permanent Pacing:

Costa

Filho

Tamaki

et al. 2003

Pacing Clinical Electrophis

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The femoral vein has been used as an alternative conduit to implant pacemakers in children of any weight. Such method associates endocardial pacing and good cosmetics. The aim of this study was to evaluate prospectively, since 1981, the long-term follow-up of 99 children, from newborn to 13 years old (average = 4.1 +/- 3.6 years, 56 girls), who underwent the implantation of pacemakers via the femoral vein. Atrioventricular block was present in 88% of patients, of congenital etiology in 39% and postoperative in 54%. Single chamber pacemakers were implanted in 92% of patients. During a mean follow-up of 5.3 +/- 5.0 years (maximum = 18.2 years), 5 patients died of cardiac causes, 4 of infection, 2 suddenly, and 3 of unknown causes. The 5-, 10- and 15-year actuarial survival rates were 83.7%, 75.7%, and 75.7%, respectively. Transfemoral leads were used for a mean of 48.9 +/- 44.0 months. Reasons for lead explantations were pacing failure in five patients, infection in eight, and elective in nine. The 2-, 5- and 10-year actuarial survivals of transfemoral leads were 87.6%, 73.8%, and 31.8%, respectively. The mean lead survival was 97 months. Overall, 105 reoperations were performed, 38 for battery depletion, 24 for body growth, 14 for infection or pocket revisions, and 27 for miscellaneous reasons. In conclusion, the durability and overall long-term performance of transfemoral leads were excellent.

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Section: Discussionmentioning

confidence: 99%