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Cardiac pacing and defibrillation in children and young adults.

Singh HR, Batra AS, Balaji S - Indian Pacing Electrophysiol J (2013)

Bottom Line: This has increased the scope and clinical indications of using these devices.As patients with congenital heart disease (CHD) comprise majority of these patients requiring devices, the knowledge of indications, pacing leads and devices, anatomical variations and the technical skills required are different than that required in the adult population.In this review we attempt to discuss these specific points in detail to improve the understanding of cardiac pacing in children and young adults.

View Article: PubMed Central - PubMed

Affiliation: The Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan.

ABSTRACT
The population of children and young adults requiring a cardiac pacing device has been consistently increasing. The current generation of devices are small with a longer battery life, programming capabilities that can cater to the demands of the young patients and ability to treat brady and tachyarrhythmias as well as heart failure. This has increased the scope and clinical indications of using these devices. As patients with congenital heart disease (CHD) comprise majority of these patients requiring devices, the knowledge of indications, pacing leads and devices, anatomical variations and the technical skills required are different than that required in the adult population. In this review we attempt to discuss these specific points in detail to improve the understanding of cardiac pacing in children and young adults.

No MeSH data available.


Related in: MedlinePlus

Dual chamber pacemaker lead implantation in a patient with left SVC without a bridging vein.
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Related In: Results  -  Collection

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Figure 1: Dual chamber pacemaker lead implantation in a patient with left SVC without a bridging vein.

Mentions: It is important to understand the anatomy and have a thorough knowledge of any underlying heart defects, presence of intracardiac shunts and type(s) of surgical procedure(s) if any performed in the past. Venography may help define presence or absence of left superior vena cava, any obstruction, or anomalies as well as patency of the vasculature if previous leads are present. Patients with d-transposition of the great arteries (d-TGA) with atrial switch operation have surgical baffles connecting the superior vena cava (SVC) and inferior vena cava to the pulmonary (left) ventricle. If placement of a lead is anticipated and there is presence of narrowing across the superior baffle, it is useful to consider stent angioplasty of the SVC baffle prior to lead implantation. Patients with previous cardiac surgery may have their right atrial appendage amputated at the time of canulation. In patients with Fontan palliation for single ventricular physiology, an atrial lead may be implanted transvenously in patients with atrio-pulmonary connection or lateral tunnel palliation (but not the extracardiac conduit), keeping in mind that they have a passive venous flow circulation. The presence of left SVC without a bridging vein can make the implantation technically challenging albeit possible (Figure 1). Future growth of the patient must be taken into account during lead implantation.


Cardiac pacing and defibrillation in children and young adults.

Singh HR, Batra AS, Balaji S - Indian Pacing Electrophysiol J (2013)

Dual chamber pacemaker lead implantation in a patient with left SVC without a bridging vein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539397&req=5

Figure 1: Dual chamber pacemaker lead implantation in a patient with left SVC without a bridging vein.
Mentions: It is important to understand the anatomy and have a thorough knowledge of any underlying heart defects, presence of intracardiac shunts and type(s) of surgical procedure(s) if any performed in the past. Venography may help define presence or absence of left superior vena cava, any obstruction, or anomalies as well as patency of the vasculature if previous leads are present. Patients with d-transposition of the great arteries (d-TGA) with atrial switch operation have surgical baffles connecting the superior vena cava (SVC) and inferior vena cava to the pulmonary (left) ventricle. If placement of a lead is anticipated and there is presence of narrowing across the superior baffle, it is useful to consider stent angioplasty of the SVC baffle prior to lead implantation. Patients with previous cardiac surgery may have their right atrial appendage amputated at the time of canulation. In patients with Fontan palliation for single ventricular physiology, an atrial lead may be implanted transvenously in patients with atrio-pulmonary connection or lateral tunnel palliation (but not the extracardiac conduit), keeping in mind that they have a passive venous flow circulation. The presence of left SVC without a bridging vein can make the implantation technically challenging albeit possible (Figure 1). Future growth of the patient must be taken into account during lead implantation.

Bottom Line: This has increased the scope and clinical indications of using these devices.As patients with congenital heart disease (CHD) comprise majority of these patients requiring devices, the knowledge of indications, pacing leads and devices, anatomical variations and the technical skills required are different than that required in the adult population.In this review we attempt to discuss these specific points in detail to improve the understanding of cardiac pacing in children and young adults.

View Article: PubMed Central - PubMed

Affiliation: The Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan.

ABSTRACT
The population of children and young adults requiring a cardiac pacing device has been consistently increasing. The current generation of devices are small with a longer battery life, programming capabilities that can cater to the demands of the young patients and ability to treat brady and tachyarrhythmias as well as heart failure. This has increased the scope and clinical indications of using these devices. As patients with congenital heart disease (CHD) comprise majority of these patients requiring devices, the knowledge of indications, pacing leads and devices, anatomical variations and the technical skills required are different than that required in the adult population. In this review we attempt to discuss these specific points in detail to improve the understanding of cardiac pacing in children and young adults.

No MeSH data available.


Related in: MedlinePlus