open access

Vol 13, No 4 (2006): Folia Cardiologica
Original articles
Published online: 2006-04-24
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Steroid-eluting epicardial pacing in children

Monika Brzezinska-Paszke, Katarzyna Bieganowska, Maria Miszczak-Knecht, Joanna Rękawek, Elżbieta Szymaniak, Agnieszka Kaszuba, Wojciech Lipiński, Mariusz Birbach
Folia Cardiol 2006;13(4):312-318.

open access

Vol 13, No 4 (2006): Folia Cardiologica
Original articles
Published online: 2006-04-24

Abstract

Background: Permanent cardiac pacing is a known method of the treatment for children with bradycardia. Epicardial pacing is required in small children and in children with some congenital heart defects. Steroid-eluting leads (SEL) have been introduced to reduce implant site fibrosis and to retain permanent low-pacing threshold values. Our aim was to evaluate the pacing characteristic and follow-up of children with epicardial steroid-eluting pacing.
Material and methods: We implanted steroid-eluting epicardial pacing systems in 53 children (age at implantation: 2 days - 17.5 years, mean 4.6 years), of whom 37 (70%) had congenital heart disease and 22 of these had already had cardiac surgery. These children formed group I. Group II was the control group and consisted of 29 children (age at implantation: 10 days - 13 years, mean 6.5 years) with non-steroid epicardial pacing systems; 15 patients (51%) had diagnosed congenital heart disease, and 9 of these had had cardiac surgery. The pacing threshold (PT) was obtained during implantation, before discharge, 1-3 and 6 months following implantation and then every 6 months.
Results: In group I the mean PT during the implantation procedure was 1.6 V/0.4 ms and decreased significantly before discharge. In group II the PT during the implantation procedure was low and increased before discharge. In group I the PT of the atrial leads was low and stable during the follow-up period, while the PT of the ventricular leads slowly increased and four years following implantation was similar to that of group II.
Conclusions: In children with permanent epicardial pacing the ventricular PT was significantly lower when steroid-eluting leads had been used then when these had not been used, but during the follow-up period the PT slowly increased, while the pacing threshold of atrial steroid-eluting leads remained stable.

Abstract

Background: Permanent cardiac pacing is a known method of the treatment for children with bradycardia. Epicardial pacing is required in small children and in children with some congenital heart defects. Steroid-eluting leads (SEL) have been introduced to reduce implant site fibrosis and to retain permanent low-pacing threshold values. Our aim was to evaluate the pacing characteristic and follow-up of children with epicardial steroid-eluting pacing.
Material and methods: We implanted steroid-eluting epicardial pacing systems in 53 children (age at implantation: 2 days - 17.5 years, mean 4.6 years), of whom 37 (70%) had congenital heart disease and 22 of these had already had cardiac surgery. These children formed group I. Group II was the control group and consisted of 29 children (age at implantation: 10 days - 13 years, mean 6.5 years) with non-steroid epicardial pacing systems; 15 patients (51%) had diagnosed congenital heart disease, and 9 of these had had cardiac surgery. The pacing threshold (PT) was obtained during implantation, before discharge, 1-3 and 6 months following implantation and then every 6 months.
Results: In group I the mean PT during the implantation procedure was 1.6 V/0.4 ms and decreased significantly before discharge. In group II the PT during the implantation procedure was low and increased before discharge. In group I the PT of the atrial leads was low and stable during the follow-up period, while the PT of the ventricular leads slowly increased and four years following implantation was similar to that of group II.
Conclusions: In children with permanent epicardial pacing the ventricular PT was significantly lower when steroid-eluting leads had been used then when these had not been used, but during the follow-up period the PT slowly increased, while the pacing threshold of atrial steroid-eluting leads remained stable.
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Keywords

permanent cardiac pacing; children; epicardial steroid-eluting electrodes

About this article
Title

Steroid-eluting epicardial pacing in children

Journal

Cardiology Journal

Issue

Vol 13, No 4 (2006): Folia Cardiologica

Pages

312-318

Published online

2006-04-24

Bibliographic record

Folia Cardiol 2006;13(4):312-318.

Keywords

permanent cardiac pacing
children
epicardial steroid-eluting electrodes

Authors

Monika Brzezinska-Paszke
Katarzyna Bieganowska
Maria Miszczak-Knecht
Joanna Rękawek
Elżbieta Szymaniak
Agnieszka Kaszuba
Wojciech Lipiński
Mariusz Birbach

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