Left ventricular (LV) pacing in newborns and infants: Echo assessment of LV systolic function and synchrony at 5‐year follow‐up

Silvetti, Massimo Stefano; Muzi, G; Unolt, Marta; D’Anna, Carolina; Saputo, Fabio Anselmo; Mambro, Corrado Di; Albanese, Sonia B.; Ammirati, Antonio; Ravà, Lucilla; Drago, Fabrizio

doi:10.1111/pace.13908

Cited by 13 publications

(14 citation statements)

References 26 publications

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“…Moreover, LVEF and LVFS improved after pacemaker implantation in patients with impaired pre-implanted LV systolic function. Silvetti et al also claimed that LV pacing could increase and normalize the LVEF for patients with depressed preoperative LVEF [9]. However, we also found that in patients with normal LV systolic function before implantation, the LVEF and LVFS rather decreased after operation, although the heart function was normal in most of them.…”

Section: Discussionsupporting

confidence: 44%

“…Second, a small part of the data, although we treated it as censored data, was missing, which may affect the results. Third, we used LVEF and LVFS, which are one-sided, to estimate the LV systolic function, and more indexes can be used, such as volumes and global longitudinal strain [9]. In this study, we focused only on the left heart function of patients.…”

Section: Limitationsmentioning

confidence: 99%

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Follow-up Results of Permanent Epicardial Pacing in Children: A 15-Year Retrospective Study

Chen

Liang

Liu

et al. 2022

Preprint

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Background Permanent epicardial pacing is an effective treatment for pediatric patients especially for those with low body weight, small body size or complex cardiac structures. This study aimed to investigate the follow-up results and identify the associated risk factors of epicardial pacing in children. Method Pediatric patients who successfully received permanent epicardial pacing treatment at Guangdong Provincial People's Hospital from March 2005 to March 2021 were included in this study. The surgical data, echocardiographic examination parameters, incidence of reoperation, and long-term complications of these patients were recorded. Result A total of 139 patients were enrolled in this study. The median follow-up period was 50 months. Compared to a baseline measurement, there was a significant decrease in the postoperative left ventricular end-diastolic diameters. For patients with left ventricular systolic dysfunction, left ventricular ejection fraction and left ventricular fractional shortening significantly improved after implantation. Thirty-one patients (22.3%) had complications in the follow-up period, and the most common was lead failure (14.4%). The reoperation incidence was 33.8%. Right ventricle pacing is a risk factor associated with reoperation. The five-years survival time of leads and batteries were 84.5% and 83.4%, respectively. Right ventricle pacing was the only risk factor which significantly reduced the lifespan of lead and battery. Conclusion Permanent epicardial pacing therapy is an effective treatment in children in spite of postoperative complications. RV pacing is a significant risk factor for reoperation, and it increases the occurrence of complications and reduces the survival time of the lead and battery.

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Section: Discussionsupporting

confidence: 44%

Section: Limitationsmentioning

confidence: 99%

Follow-up Results of Permanent Epicardial Pacing in Children: A 15-Year Retrospective Study

Chen

Liang

Liu

et al. 2022

Preprint

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“… 5 Left ventricle diameters, LVEF, SF, and strain were monitored prospectively in another trial of 20 patients; LV functions and diameters were preserved with LV pace and synchronization was determined to be satisfactory. 15 It was revealed that the presence of maternal antibodies had no effect. 15 In comparison to other studies, the frequency of LV dysfunction in our study was much lower (2.7%).…”

Section: Discussionmentioning

confidence: 99%

“… 15 It was revealed that the presence of maternal antibodies had no effect. 15 In comparison to other studies, the frequency of LV dysfunction in our study was much lower (2.7%). This might be due to the fact that our clinic uses LV apical pacing as a PM placement approach.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Mid-term Follow-up in Children with Isolated Complete Atrioventricular Block

et al. 2023

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Background: Isolated complete atrioventricular block is a rare disease often associated with maternal autoantibodies. This study aimed to present the mid-term data of patients at our clinic diagnosed with isolated complete atrioventricular block. Methods: We evaluated 108 patients diagnosed with isolated complete atrioventricular block. Demographic data of the patients, electrocardiography, echocardiography, 24-hour Holter monitoring data, and follow-up and complications of the patients who underwent pacemaker implantation were evaluated retrospectively. Results: The mean age of the patients at diagnosis was 5.51 ± 5.05 years. At the time of diagnosis, 74.8% of the patients had no symptoms associated with complete atrioventricular block. The most common symptom was fatigue. Pacemaker implantation was needed in 88 (81.4%) patients during follow-up. Significant bradycardia was the most common pacemaker implantation indication. The mean battery life was 5.41 ± 2.65 years. The battery replacement-free period of 68 patients who underwent pacemaker implantation and continued their follow-up was 4.18 ± 2.89 (0.1-10) years. Pacemaker-related complications developed in 8 patients during follow-up. Left ventricular dysfunction developed (dyssynchrony induced) in 3 patients at follow-up, and all were paced from the right ventricular anterior wall. Those patients underwent cardiac resynchronization therapy and their left ventricular dysfunction improved. Conclusion: Isolated complete atrioventricular block is a rare disease requiring careful clinical follow-up. Patients are often asymptomatic and significant bradycardia is the most common indication for pacemaker implantation. Left ventricular dysfunction is an important cause of morbidity, especially in patients with right ventricular anterior wall pacing. Physicians should be aware of left ventricular dysfunction during follow-up. Cardiac resynchronization therapy should be considered as a treatment option for left ventricular dysfunction.

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“… 12 Their findings were further supported by a previous large retrospective pediatric multicenter survey 13 and previous studies that showed preservation of left ventricular function with left ventricular apical or left ventricular lateral wall pacing. 14 , 15 , 16 , 17 , 18 , 19 …”

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes of pacemaker implantation in children with univentricular versus complex biventricular surgical repair

Spentzou

Taylor

Zhang

et al. 2023

Journal of Arrhythmia

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Objective: Pacing in a univentricular circulation has been associated with worsened outcomes. We investigated the long-term outcomes of pacing in children with a univentricular circulation compared to a complex biventricular circulation. We also identified predictors of adverse outcomes.Methods: A retrospective study of all children with major congenital heart disease who underwent pacemaker implantation under the age of 18 years between November 1994 and October 2017.Results: Eighty-nine patients were included; 19 with a univentricular and 70 with a complex biventricular circulation. A total of 96% of pacemaker systems were epicardial. Median follow up was 8.3 years. The incidence of adverse outcome was similar between the two groups. Five (5.6%) patients died and two (2.2%) underwent heart transplantation. Most adverse events occurred within the first 8 years after pacemaker implantation. Univariate analysis identified five predictors of adverse outcomes in the patients in the biventricular but none in the univentricular group. The predictors of adverse outcome in the biventricular circulation were a right morphologic ventricle as the systemic ventricle, age at first congenital heart disease (CHD) operation, number of CHD operations, and female gender. The nonapical lead position was associated with a much higher risk of an adverse outcome. Conclusions:Children with a pacemaker and a complex biventricular circulation have similar survival to the ones with a pacemaker and a univentricular circulation. The only modifiable predictor was the epicardial lead position on the paced ventricle, emphasizing the importance of apical placement of the ventricular lead.

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Left ventricular (LV) pacing in newborns and infants: Echo assessment of LV systolic function and synchrony at 5‐year follow‐up

Cited by 13 publications

References 26 publications

Follow-up Results of Permanent Epicardial Pacing in Children: A 15-Year Retrospective Study

Follow-up Results of Permanent Epicardial Pacing in Children: A 15-Year Retrospective Study

Clinical Characteristics and Mid-term Follow-up in Children with Isolated Complete Atrioventricular Block

Long‐term outcomes of pacemaker implantation in children with univentricular versus complex biventricular surgical repair

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