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Article: Permanent cardiac pacing in children: Choosing the optimal pacing site: A multicenter study

TitlePermanent cardiac pacing in children: Choosing the optimal pacing site: A multicenter study
Authors
Keywordspediatrics
pacemakers
heart failure
Heart block
pacing
Issue Date2013
Citation
Circulation, 2013, v. 127, n. 5, p. 613-623 How to Cite?
AbstractBACKGROUND-: We evaluated the effects of the site of ventricular pacing on left ventricular (LV) synchrony and function in children requiring permanent pacing. METHODS AND RESULTS-: One hundred seventy-eight children (aged <18 years) from 21 centers with atrioventricular block and a structurally normal heart undergoing permanent pacing were studied cross-sectionally. Median age at evaluation was 11.2 (interquartile range, 6.3-15.0) years. Median pacing duration was 5.4 (interquartile range, 3.1-8.8) years. Pacing sites were the free wall of the right ventricular (RV) outflow tract (n=8), lateral RV (n=44), RV apex (n=61), RV septum (n=29), LV apex (n=12), LV midlateral wall (n=17), and LV base (n=7). LV synchrony, pump function, and contraction efficiency were significantly affected by pacing site and were superior in children paced at the LV apex/LV midlateral wall. LV dyssynchrony correlated inversely with LV ejection fraction (R=0.80, P=0.031). Pacing from the RV outflow tract/lateral RV predicted significantly decreased LV function (LV ejection fraction <45%; odds ratio, 10.72; confidence interval, 2.07-55.60; P=0.005), whereas LV apex/LV midlateral wall pacing was associated with preserved LV function (LV ejection fraction ≥55%; odds ratio, 8.26; confidence interval, 1.46-47.62; P=0.018). Presence of maternal autoantibodies, gender, age at implantation, duration of pacing, DDD mode, and QRS duration had no significant impact on LV ejection fraction. CONCLUSIONS-: The site of ventricular pacing has a major impact on LV mechanical synchrony, efficiency, and pump function in children who require lifelong pacing. Of the sites studied, LV apex/LV midlateral wall pacing has the greatest potential to prevent pacing-induced reduction of cardiac pump function. © 2012 American Heart Association, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/268925
ISSN
2017 Impact Factor: 18.881
2015 SCImago Journal Rankings: 7.853

 

DC FieldValueLanguage
dc.contributor.authorJanoušek, Jan-
dc.contributor.authorVan Geldorp, Irene E.-
dc.contributor.authorKrupičková, Sylvia-
dc.contributor.authorRosenthal, Eric-
dc.contributor.authorNugent, Kelly-
dc.contributor.authorTomaske, Maren-
dc.contributor.authorFrüh, Andreas-
dc.contributor.authorElders, Jan-
dc.contributor.authorHiippala, Anita-
dc.contributor.authorKerst, Gunter-
dc.contributor.authorGebauer, Roman A.-
dc.contributor.authorKubuš, Peter-
dc.contributor.authorFrias, Patrick-
dc.contributor.authorGabbarini, Fulvio-
dc.contributor.authorClur, Sally Ann-
dc.contributor.authorNagel, Bert-
dc.contributor.authorGaname, Javier-
dc.contributor.authorPapagiannis, John-
dc.contributor.authorMarek, Jan-
dc.contributor.authorTisma-Dupanovic, Svjetlana-
dc.contributor.authorTsao, Sabrina-
dc.contributor.authorNürnberg, Jan Hendrik-
dc.contributor.authorWren, Christopher-
dc.contributor.authorFriedberg, Mark-
dc.contributor.authorDe Guillebon, Maxime-
dc.contributor.authorVolaufova, Julia-
dc.contributor.authorPrinzen, Frits W.-
dc.contributor.authorDelhaas, Tammo-
dc.date.accessioned2019-04-07T15:08:55Z-
dc.date.available2019-04-07T15:08:55Z-
dc.date.issued2013-
dc.identifier.citationCirculation, 2013, v. 127, n. 5, p. 613-623-
dc.identifier.issn0009-7322-
dc.identifier.urihttp://hdl.handle.net/10722/268925-
dc.description.abstractBACKGROUND-: We evaluated the effects of the site of ventricular pacing on left ventricular (LV) synchrony and function in children requiring permanent pacing. METHODS AND RESULTS-: One hundred seventy-eight children (aged <18 years) from 21 centers with atrioventricular block and a structurally normal heart undergoing permanent pacing were studied cross-sectionally. Median age at evaluation was 11.2 (interquartile range, 6.3-15.0) years. Median pacing duration was 5.4 (interquartile range, 3.1-8.8) years. Pacing sites were the free wall of the right ventricular (RV) outflow tract (n=8), lateral RV (n=44), RV apex (n=61), RV septum (n=29), LV apex (n=12), LV midlateral wall (n=17), and LV base (n=7). LV synchrony, pump function, and contraction efficiency were significantly affected by pacing site and were superior in children paced at the LV apex/LV midlateral wall. LV dyssynchrony correlated inversely with LV ejection fraction (R=0.80, P=0.031). Pacing from the RV outflow tract/lateral RV predicted significantly decreased LV function (LV ejection fraction <45%; odds ratio, 10.72; confidence interval, 2.07-55.60; P=0.005), whereas LV apex/LV midlateral wall pacing was associated with preserved LV function (LV ejection fraction ≥55%; odds ratio, 8.26; confidence interval, 1.46-47.62; P=0.018). Presence of maternal autoantibodies, gender, age at implantation, duration of pacing, DDD mode, and QRS duration had no significant impact on LV ejection fraction. CONCLUSIONS-: The site of ventricular pacing has a major impact on LV mechanical synchrony, efficiency, and pump function in children who require lifelong pacing. Of the sites studied, LV apex/LV midlateral wall pacing has the greatest potential to prevent pacing-induced reduction of cardiac pump function. © 2012 American Heart Association, Inc.-
dc.languageeng-
dc.relation.ispartofCirculation-
dc.subjectpediatrics-
dc.subjectpacemakers-
dc.subjectheart failure-
dc.subjectHeart block-
dc.subjectpacing-
dc.titlePermanent cardiac pacing in children: Choosing the optimal pacing site: A multicenter study-
dc.typeArticle-
dc.description.natureLink_to_OA_fulltext-
dc.identifier.doi10.1161/CIRCULATIONAHA.112.115428-
dc.identifier.pmid23275383-
dc.identifier.scopuseid_2-s2.0-84873571540-
dc.identifier.volume127-
dc.identifier.issue5-
dc.identifier.spage613-
dc.identifier.epage623-
dc.identifier.eissn1524-4539-

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