Performance of epimyocardial leads in patients with a single ventricle circulation.
Pacing Clin Electrophysiol
; 44(5): 903-910, 2021 May.
Article
em En
| MEDLINE
| ID: mdl-33687754
ABSTRACT
BACKGROUND:
Cardiac pacing can be challenging after a Fontan operation, and limited data exist regarding strategies to plan these epimyocardial systems while minimizing the number of surgical procedures.METHODS:
A retrospective review of all our 47 patients (mean age 18 years, standard deviation 9 years) with a Fontan palliation who received an epimyocardial cardiac implantable electronic device (CIED) between 2002 and 2020 with regard to the stability of the epimyocardial lead parameters and the incidence of system revisions.RESULTS:
Over the last 18 years, 84 implantations or revisions of the epimyocardial CIED in 47 Fontan patients were performed. Mean age at time of the first implantation was 9.4 (range 0.28-29.3) years. Follow-up period ranges from 0.11 to 18.2 (mean 7.7, standard deviation 4.2) years. A total of 123 pacing leads were implanted of which 99 are still active. From 2010 triple lead cardiac resynchronization devices were used in 17 patients to better cope with lead problems. The initial pacing threshold of the leads inactivated during this study period proved significantly higher (mean 1.66 V) than in the "all leads" group (mean 1.27 V, p = .0005) or the group of the still active leads (mean 1.17 V, p = .00004).CONCLUSIONS:
When implanted with a low pacing threshold, the bipolar epimyocardial electrodes show stable and good long-term results in young patients with a Fontan circulation. Resynchronization pacing systems and the prospective implantation of reserve leads may help to reduce the rate of resternotomies and provide a flexible concept to deal with lead failure.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Marca-Passo Artificial
/
Estimulação Cardíaca Artificial
/
Técnica de Fontan
/
Eletrodos Implantados
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Alemanha