Transmural Atrial Pacing in Patients with Postoperative Congenital Heart Disease
- 1 March 1999
- journal article
- research article
- Published by Wiley in Journal of Cardiovascular Electrophysiology
- Vol. 10 (3), 351-357
- https://doi.org/10.1111/j.1540-8167.1999.tb00682.x
Abstract
Transmural Pacing in Congenital Heart Disease. Introduction: Some patients with postoperative congenital heart disease require permanent cardiac pacing, but the use of transvenous or epicardial pacing leads may be limited by type of cardiac malformation, venous connections, body size, or fibrosis. Transmural atrial pacing may provide an alternative in difficult patients, but to date has been described in only a few articles with small patient numbers, and data from lead performance are lacking. Methods and Results: Records were reviewed in 18 consecutive patients (4 months to 21 years old) with postoperative congenital heart disease receiving transmural atrial pacing leads from July 1994 to December 1996. Implantation materials and techniques were described. Lead sensing and capture thresholds obtained acutely and during short‐term follow‐up (mean: 11.0 months) were evaluated, and comparisons were made between patients with postoperative Fontan anatomy and non‐Fontan patients, and between patients receiving steroid‐eluting and nonsteroid leads. Overall, the median acute sensing and capture thresholds of transmural leads were 4.1 mV and 0.7 V at 0.5 msec, respectively. Median follow‐up thresholds were 2.8 mV and 0.8 V, respectively. Performance of leads in Fontan patients was similar to those in non‐Fontan patients. Steroid‐eluting leads had a chronic capture threshold of 0.6 V versus 0.9 V for nonsteroid leads (P = 0.038). Conclusion: Transmural atrial pacing leads were successfully implanted in patients with diverse ages and types of postoperative congenital heart disease. Lead performance was acceptable both acutely and during the first year of follow‐up.Keywords
This publication has 19 references indexed in Scilit:
- Transatrial lead placement for endocardial pacing in childrenThe Annals of Thoracic Surgery, 1994
- Malposition of Transvenous Pacing Lead in the Left VentriclePacing and Clinical Electrophysiology, 1993
- Atrioventricular pacing in congenital heart diseaseThe Annals of Thoracic Surgery, 1992
- Improved Chronic Epicardial Pacing in Children: Steroid Contribution to Porous Platinized ElectrodesPacing and Clinical Electrophysiology, 1992
- Steroid-Eluting Epicardial Leads in Pediatrics: Improved Epicardial Thresholds in the First YearPacing and Clinical Electrophysiology, 1991
- Transatrial Implantation of Transvenous Pacing Leads is an Alternative to Implantation of Epicardial LeadsPacing and Clinical Electrophysiology, 1990
- A transmural approach for endocardial ventricular pacingThe American Journal of Cardiology, 1990
- Pacemakers in children: An updateAmerican Heart Journal, 1989
- Transthoracic Transatrial Endocardial Lead Placement for Permanent PacingThe Annals of Thoracic Surgery, 1987
- Permanent Atrial Electrode PlacementThe Annals of Thoracic Surgery, 1982