Pacemaker implantation in pediatric heart transplant recipients: Predictors, outcomes, and impact on survival

El-Assaad, Iqbal; Al‐Kindi, Sadeer G.; Oliveira, Guilherme H.; Houghtaling, Penny L.; Wilkoff, Bruce L.; Boyle, Gerard J.; Aziz, Peter F.

doi:10.1016/j.hrthm.2015.04.045

Cited by 18 publications

(26 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Kaplan‐Meier estimation and log‐rank testing showed there was no statistically significant difference in survival between children who were paced and those who were not paced during long‐term follow‐up. This is in agreement with previous pediatric and adult studies comparing survival between post‐transplant PPM recipients and controls, which also collectively demonstrate no difference of statistical significance between these two patient groups.…”

Section: Discussionsupporting

confidence: 92%

“…Higher donor age was linked with the need for PPM implantation in children following OHT in this study. This finding is in concordance with two previous pediatric studies that demonstrated significant associations between increasing donor age and PPM requirement . Additionally, on unifactorial analysis, patients who were paced were significantly more likely to have had a donor‐to‐recipient weight ratio >2.0 in comparison with those who were not paced.…”

Section: Discussionsupporting

confidence: 91%

“…Moreover, Herrmann et al identified an incidence of 12.3% at a mean follow‐up of 8 years. Our paper analyzed a more recent pediatric patient cohort who had solely undergone OHT using the bicaval method (as opposed to both bicaval and biatrial transplant techniques which were utilized in the patients of the aforementioned pediatric studies), and studies have established a lower incidence of PPM implantation in children and adults receiving bicaval anastomosis in comparison with biatrial anastomosis, thought most likely due to preservation of the integrity of the donor right atrium …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Permanent pacemaker implantation after pediatric heart transplantation: Risk factors, indications, and outcomes

Mahmood

Andrews

Fenton

et al. 2019

Clinical Transplantation

View full text Add to dashboard Cite

Background Permanent pacemaker (PPM) placement in adults following orthotopic heart transplantation (OHT) has been well documented. However, studies concerning the need for PPM implantation in pediatric heart transplant recipients are less common. Methods Institutional transplant and pacing databases as well as patient medical records were reviewed for all pediatric patients undergoing OHT (n = 314; all with bicaval connection) at our institution between January 2000 and March 2018. Results A total of 16 patients (5.1%) were implanted with a pacemaker after transplantation. Donor age was the only significant risk factor for post‐transplant PPM implantation, with a median age of 28.5 years (7.0‐49.0) in the pacing group vs 15.5 years (0.4‐56.0) in the non‐pacing group (P = 0.009). Indication for pacemaker insertion was more often complete heart block (CHB) (12/16, 75%) than sinus node dysfunction (SND) (4/16, 25%). There was no significant difference in mortality between recipients who received a PPM and those who did not (log‐rank test; P = 0.345). Conclusions Increasing donor age is associated with increased PPM placement following pediatric heart transplantation. Interestingly, a high proportion of CHB patients recovered sinus rhythm, and long‐term outcomes for paced patients are similar to other heart transplant recipients.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Permanent pacemaker implantation after pediatric heart transplantation: Risk factors, indications, and outcomes

Mahmood

Andrews

Fenton

et al. 2019

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…Patients with the biatrial anastomosis have a good long‐term prognosis, and Cantillon et al found better survival in biatrial anastomosis patients with a PM compared to those that did not . A similar study for the PHTx population examined the UNOS database for the acute need (during the patient's operative transplant hospitalization) for a PM . They also found biatrial anastomosis as an associated factor for PM implantation, in addition to pre‐transplant use of antiarrhythmic medications.…”

Section: Discussionmentioning

confidence: 99%

Fatal cardiac arrest in pediatric heart transplant recipients: Query of the UNOS database

Loar

Denfield

Morris

et al. 2017

Pediatric Transplantation

View full text Add to dashboard Cite

The incidence of death by CA after PHTx is unknown. We aimed to determine the incidence and factors for fatal CA after PHTx, and whether a PM affects survival. Retrospective cohort study utilizing the United Network of Organ Sharing registry of patients transplanted ≤18 years. Multivariable analyses in hazard-function domain and Kaplan-Meier analyses were performed for an outcome of death due to CA. There were 7719 PHTx patients queried. CA was the reported cause of death in 11%. Age ≥13 years at time of transplant, presence of a PM, and depressed EF were identified as significant factors for fatal CA. Death due to CA beyond 10 years post-transplant was associated with depressed EF, CAV, and presence of a PM. Kaplan-Meier analysis demonstrated higher likelihood of fatal CA in patients with CAV and in those with a PM vs those without. In total, 15% of patients with a PM died from CA. CA is a relatively common cause of death after PHTx. The benefit of a PM remains unclear, but its presence does not confer complete protection. Patients with associated factors warrant vigilant surveillance and consideration for retransplantation.

show abstract

“…Amiodarone therapy before a heart transplant has also been identified as an independent variable with a higher rate of permanent pacemaker implantation during the immediate postoperative period, both for adults and children …”

Section: Discussionmentioning

confidence: 99%

Incidence and causes of pacemaker implantation during postoperative period of aortic valve replacement with rapid deployment prosthesis

Arribas

Soriano

Rivera‐Caravaca

et al. 2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Background Aortic stenosis is currently the most frequently occurring valve pathology. Developments, such as transcatheter prostheses and rapid deployment prostheses, allow for the offer of a valve replacement to higher risk patients, but these techniques are linked with a higher need for a permanent pacemaker during the immediate postoperative period. Methods We studied the incidence and the factors associated with permanent pacemaker implantation after aortic valve replacement with Edwards Intuity rapid deployment prosthesis. Results Between October 2012 and December 2016, the Edwards Intuity prosthesis was implanted in 71 patients (68% male, 75.3 ± 5 years old). Six patients (8%) required a permanent pacemaker during immediate postoperative period. Univariate analysis showed that a history of acute myocardial infarction (AMI) (P = .046, B = 7.5, 95% CI [1.039‐54.1]) and preoperative amiodarone (P = .009, B = 31.5; 95% CI [2.32‐426]) were associated with a higher need for a pacemaker during the postoperative period. Conclusions The incidence of permanent pacemaker implantation during the immediate postoperative period of aortic valve replacement with Edwards Intuity prosthesis was 8%, a value which is within the limits reported for conventional aortic prostheses. Preoperative amiodarone treatment and previous AMI may increase the need for a pacemaker during the postoperative period of these aortic prostheses.

show abstract

Pacemaker implantation in pediatric heart transplant recipients: Predictors, outcomes, and impact on survival

Cited by 18 publications

References 16 publications

Permanent pacemaker implantation after pediatric heart transplantation: Risk factors, indications, and outcomes

Permanent pacemaker implantation after pediatric heart transplantation: Risk factors, indications, and outcomes

Fatal cardiac arrest in pediatric heart transplant recipients: Query of the UNOS database

Incidence and causes of pacemaker implantation during postoperative period of aortic valve replacement with rapid deployment prosthesis

Contact Info

Product

Resources

About