Permanent Endovenous Pediatric Pacing: Absence of Lead Failure—20 Years Follow‐Up Study

Abstract

Implantation of the endovenous leads by preparation of the cephalic or puncture of the axillary vein, with lead fixation by resorbable suture represents a method of choice.

Initial Experience of Pacing with a Lumenless Lead System in Patients with Congenital Heart Disease

“…In previous studies of pacing in patients with CHD, the overall rate of lead‐related complications have been reported as high as 27% due in part to difficulty in accessing and pacing these anatomically varied and surgically distorted hearts 12 . In a recent study, Stojanov et al 17 have reported a zero percent lead displacement in pediatric patients. However, the majority of the leads (105 of 121) were implanted in the ventricular apex passively.…”

Cardiac pacing in infants and children

“…Some operators ‘use up’ part of the redundant lead by making the generator pocket below the axilla and tunnelling the lead from the infraclavicular region to the subaxillary pocket, which is better cosmetically. An alternative approach is to make a subaxillary pocket and implant the lead via the axillary vein 13 . w25 This approach is likely to be preferred by image conscious children and teenagers as there are no scars over the anterior chest wall.…”

“…w25 This approach is likely to be preferred by image conscious children and teenagers as there are no scars over the anterior chest wall. In addition, a cephalic or axillary vein approach reduces the risk of crush fracture associated with implantation via the subclavian vein 13 . w25 w26 …”

“…Despite promising titles, the maximum mean or median follow-up of any of the studies of long term pacing in children is <10 years, a mere fraction of the life expectancy of a child 7 8 12 13 . w45 As yet, we do not know what will be the true long term outcome of decades of pacing beginning in childhood.…”

Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management

“…Extraction of abandoned transvenous leads in the pediatric population is also problematic, and optimal lead management still remains to be defined [17, 60]. On the other hand, there is a global trend towards using endocardial leads in younger patients and some institutions actively implant transvenous leads in children weighing less than 15 kg [43, 63, 73, 79, 83, 85]. It has been shown that an 80-mm right atrial lead loop will allow 6 to 12 years (mean, 8 years) of growth in infants and children without the need for reoperation to adjust lead length [33] (Figs.…”