Temporary neonatal atrial pacing through the umbilical venous route: A novel technique

Doshi, Hiren; Lokare, Seema T

doi:10.4103/0974-2069.84661

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…Transcutaneous pacing provides immediate pacing and is indicated and lifesaving in neonates with congenital heart blocks. Although in a recent case series transvenous pacing has been used successfully to pace neonates,[ 11 ] it is generally contraindicated in this patient group due to small body size, probable right to left heart shunt as well as possible of venous obstruction due to small size of veins. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management of a 2-day-old with complete congenital heart block

et al. 2014

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Maternal connective tissue disorders such as Systemic Lupus Erythematosus (most common), Sjogren's syndrome, mixed connective tissue disorders may lead to the rare condition of complete congenital heart block in the neonate. Rare fetal syndromes such as myocarditis, 18p syndrome, mucopolysaccharidoses and mitochondrial diseases are other causes. The mortality rate of this condition is inversely propotional to the age of presentation being 6 % in the neonatal age group. As the cardiac output in the neonate is heart rate dependent, it is crucial to maintain the heart rate in these patients. Pharamacological interventions with dopamine, isoprenaline, epinephrine and atropine are known for their variable response. Although permanent pacing is the most reliable mode of management, the access to it is often not readily available, especially in the developing countries. In such cases temporary pacing methods become lifesaving. Of all the modalities of temporary pacing (transcutaneous, transesophageal and transvenous) transcutaneous pacing is the most readily available and immediate mode. In this case report we present a two day old neonate with isolated complete congenital heart block and a resting heart rate of 50-55/min in immediate need of palliative surgery for trachea-esophageal fistula (TEF). With pharmacological intervention the heart rate could only be raised to 75-80/min. The surgery was successfully carried out using transcutaneous pacing to maintain a heart rate of 100/min.

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Section: Discussionmentioning

confidence: 99%

Anesthetic management of a 2-day-old with complete congenital heart block

et al. 2014

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Perinatal Arrhythmias

Chun¹,

Arya²

2018

Avery's Diseases of the Newborn

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Temporary pacemaker implantation through umbilical vein in a low birth weight neonate with congenital complete heart block

2021

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Congenital heart block is a rare and lethal condition in paediatric population associated with maternal connective tissue disorders and rarely with structural cardiac disease like atrioventricular canal defects with or without left isomerism and congenitally corrected transposition of great arteries. Pacing in neonate if indicated is generally accomplished by epicardial pacing systems. However, in cases of significant bradycardia and haemodynamic instability, temporary pacemaker implantation via transvenous approach remains as a suitable option. Despite the advances in percutaneous catheter interventions, use of transvenous pacing in newborn is extremely challenging due to inadvertent risk of vessel injury, thrombus formation and mortality, and most of the time technical inability to place the lead within the right ventricular cavity. We report a case of congenital complete atrioventricular block in a premature male with birth weight of 1.51 kg who was managed with temporary pacemaker implantation through umbilical vein.

show abstract

Temporary neonatal atrial pacing through the umbilical venous route: A novel technique

Cited by 3 publications

References 4 publications

Anesthetic management of a 2-day-old with complete congenital heart block

Anesthetic management of a 2-day-old with complete congenital heart block

Perinatal Arrhythmias

Temporary pacemaker implantation through umbilical vein in a low birth weight neonate with congenital complete heart block

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