Permanent epicardial pacing in children: long-term results and factors modifying outcome

Abstract

The probability of continued epicardial pacing in children was 76% at 10 years after implantation, increased for implantation in recent years, and allowed transvenous pacing to be deferred to a significantly greater age. The use of bipolar steroid-eluting leads and of a beat-to-beat capture tracking feature significantly increased pacing system longevity and decreased the need for surgical reinterventions.

Long-term atrial and ventricular epicardial pacemaker lead survival after cardiac operations in pediatric patients with congenital heart disease

“…These findings demonstrate that overall epicardial lead survival is significantly better than that reported in previous studies in the pediatric population. 2,6,11,12,[16][17][18][19] In mixed pediatric cohorts consisting of patients with and without CHD, the short-term (2-2.5 years) and midterm (5-6 years) incidence of epicardial lead malfunction has previously been reported to be 10%-34% and 26%-40%, respectively, with a paucity of long-term data. 12,17,20,21 Murayama et al 20 identified the presence of CHD as predictive of subsequent lead malfunction, imparting a 2.9-fold increase in risk compared with those implanted in patients without CHD.…”

Comparison of delayed transvenous reimplantation and immediate surgical epicardial approach in pacing-dependent patients undergoing extraction of infected permanent pacemakers

“…26 The period of long-term follow-up was relatively short (1 year), and this may be particularly important in the EPI group because with longer follow-up periods more problems may be related to failure of epicardial pacing leads, which is well described. 27 …”

Twenty-Seven Years Experience With Transvenous Pacemaker Implantation in Children Weighing <10 kg

“…In a series of 119 epicardial pacemakers implanted at a mean age of 1.8 years with a median follow-up of 6.4 years, there were pocket complications in 6.7% and lead fractures or exit block in 20%. 18 Other procedural complications included hemothoraces and pericardial effusions. We had 4 patients who required early reintervention because of complications (skin erosion/infection in 2 and lead displacement/malposition in 2), 1 late pocket infection, and 1 late endocarditis.…”