Pacemaker Therapy in Children With Complete Heart Block

Abstract

Permanent pacemaker therapy in children with complete heart block is necessary occasionally. Ten patients ranging in age from 8 months to 15 years were treated with an implanted P-wave, synchronous epicardial pacemaker. Indications for implantation were persisting postsurgical heart block, congestive failure, syncopal attacks, and arrhythmias. There were two deaths not attributed to pacemaker malfunction. The remaining eight children have been followed up for 38 to 108 months. There have been 27 pulse generator replacements. Twenty-three were for battery exhaustion, three for electromechanical failure, and one was due to arrhythmia. Rhythm disturbances have occurred on eight occasions. There have been no infections. It is concluded that the implanted P\ x =r eq-\ wave synchronous pacemaker is an effective method of therapy when indicated for children with complete heart block.

Late recovery of atrioventricular conduction after pacemaker implantation for complete heart block in congenital heart disease: fact or fluke ?*

“…The incidence of postoperative AV conduction block has declined significantly since the necessity for PM implantation was first demonstrated by Lillehei et al in 1963 (1). The impact of PM implantation on improving outcome of post-surgical CHB was borne by a number of subsequent retrospective reports (5,8,(13)(14)(15). Murphy et al reported that approximately half of 40 patients who presented with CHB in the immediate postoperative period regained AV conduction, but this occurred within a month after surgery in most of them.…”

Congenital Complete Heart Block

“…Procedure. The following recommendations are based on our own experience from pacing in 31 infants and children and on reported experience from pacing in another 59 infants and children (18,19,20,21). Different types of PM have been used, but the QRS inhibited lithium PM is the one most commonly recommended.…”