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Article: Dual-chamber epicardial pacing in neonates with congenital heart block

TitleDual-chamber epicardial pacing in neonates with congenital heart block
Authors
Issue Date2007
Citation
Journal of Thoracic and Cardiovascular Surgery, 2007, v. 134, n. 5, p. 1188-1192 How to Cite?
AbstractObjective: This review evaluates the outcome of a treatment strategy using dual-chamber pacemakers for neonates with congenital heart block. Methods: From 1989 to 2006, 10 neonates had dual-chamber epicardial pacemaker placement for congenital heart block. Mean age and weight were 4.4 ± 5.6 days and 2.8 ± 0.6 kg. Four patients had heterotaxy syndrome and required concomitant cardiac procedures. One patient had fetal hydrops, myocarditis, and cardiomyopathy. Five patients had structurally normal hearts. Sternotomy (2 partial, 8 full) and unipolar leads (2 non-steroid eluting, 18 steroid-eluting) were used in all. Generators were placed in submuscular bilateral rectus sheath pockets. Results: Successful atrioventricular synchrony was established in all patients. Mean P-wave sensing was 4.7 ± 2.6 mV and atrial voltage threshold was 0.8 ± 0.3 V. Mean R-wave sensing was 13.0 ± 5.7 mV and ventricular voltage threshold 0.9 ± 0.5 V. There were no wound complications or acute lead failures. Median postoperative stay was 14 days. Three of the 4 patients with heterotaxy died at 3 days, 14 days, and 15 months postoperatively. The patient with cardiomyopathy died suddenly at 6 months of acute myocarditis. No patient with a structurally normal heart died (P < .05). Mean follow-up interval in survivors is 6.1 ± 7.1 years with 1 patient lost to follow-up. Conclusions: Implantation of a dual-chamber epicardial pacemaker in neonates with congenital heart block is technically feasible and results in excellent outcomes in patients with structurally normal hearts. System longevity at 6 years is excellent. Patients with congenital heart block and heterotaxy syndrome have a poor prognosis despite dual-chamber pacing. © 2007 The American Association for Thoracic Surgery.
Persistent Identifierhttp://hdl.handle.net/10722/268919
ISSN
2023 Impact Factor: 4.9
2023 SCImago Journal Rankings: 1.744
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKelle, Angela M.-
dc.contributor.authorBacker, Carl L.-
dc.contributor.authorTsao, Sabrina-
dc.contributor.authorStewart, Robert D.-
dc.contributor.authorFranklin, Wayne H.-
dc.contributor.authorDeal, Barbara J.-
dc.contributor.authorMavroudis, Constantine-
dc.date.accessioned2019-04-07T15:08:54Z-
dc.date.available2019-04-07T15:08:54Z-
dc.date.issued2007-
dc.identifier.citationJournal of Thoracic and Cardiovascular Surgery, 2007, v. 134, n. 5, p. 1188-1192-
dc.identifier.issn0022-5223-
dc.identifier.urihttp://hdl.handle.net/10722/268919-
dc.description.abstractObjective: This review evaluates the outcome of a treatment strategy using dual-chamber pacemakers for neonates with congenital heart block. Methods: From 1989 to 2006, 10 neonates had dual-chamber epicardial pacemaker placement for congenital heart block. Mean age and weight were 4.4 ± 5.6 days and 2.8 ± 0.6 kg. Four patients had heterotaxy syndrome and required concomitant cardiac procedures. One patient had fetal hydrops, myocarditis, and cardiomyopathy. Five patients had structurally normal hearts. Sternotomy (2 partial, 8 full) and unipolar leads (2 non-steroid eluting, 18 steroid-eluting) were used in all. Generators were placed in submuscular bilateral rectus sheath pockets. Results: Successful atrioventricular synchrony was established in all patients. Mean P-wave sensing was 4.7 ± 2.6 mV and atrial voltage threshold was 0.8 ± 0.3 V. Mean R-wave sensing was 13.0 ± 5.7 mV and ventricular voltage threshold 0.9 ± 0.5 V. There were no wound complications or acute lead failures. Median postoperative stay was 14 days. Three of the 4 patients with heterotaxy died at 3 days, 14 days, and 15 months postoperatively. The patient with cardiomyopathy died suddenly at 6 months of acute myocarditis. No patient with a structurally normal heart died (P < .05). Mean follow-up interval in survivors is 6.1 ± 7.1 years with 1 patient lost to follow-up. Conclusions: Implantation of a dual-chamber epicardial pacemaker in neonates with congenital heart block is technically feasible and results in excellent outcomes in patients with structurally normal hearts. System longevity at 6 years is excellent. Patients with congenital heart block and heterotaxy syndrome have a poor prognosis despite dual-chamber pacing. © 2007 The American Association for Thoracic Surgery.-
dc.languageeng-
dc.relation.ispartofJournal of Thoracic and Cardiovascular Surgery-
dc.titleDual-chamber epicardial pacing in neonates with congenital heart block-
dc.typeArticle-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1016/j.jtcvs.2007.04.049-
dc.identifier.pmid17976448-
dc.identifier.scopuseid_2-s2.0-35548957726-
dc.identifier.volume134-
dc.identifier.issue5-
dc.identifier.spage1188-
dc.identifier.epage1192-
dc.identifier.isiWOS:000250576200013-
dc.identifier.issnl0022-5223-

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