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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

Use of an ICD coil in the left axillary vein in a patient with right sided generator implant to lower the DFTs. The atrial lead is in the posterior high right atrial septum near the Bachmann's bundle.
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Figure 2: Use of an ICD coil in the left axillary vein in a patient with right sided generator implant to lower the DFTs. The atrial lead is in the posterior high right atrial septum near the Bachmann's bundle.

Mentions: Based on variations in anatomy, the lead implantation technique may have to be revised. In patients with high DFTs at the time of ICD implantation, additional coils or subcutaneous array are implanted.[32] The placement of additional coils can be in the coronary sinus, azygous vein, or the left innominate or axillary vein (Figure 2). Implanting the device in the left axillary region has also been postulated to reduce the DFT.[33] Use of medications like Sotalol has been reported to lower the DFT .[34,35] In some group of patients a 'hybrid' approach to lead implantation is performed. If biventricular pacing is contemplated in patients with d-TGA with atrial switch palliation, a mini-sternotomy or thoracotomy is used to implant the systemic (RV) ventricular epicardial lead that is tunneled to the pocket where the generator with the transvenous leads is placed. In very small patients, ICD is implanted using a pericardial patch or a coil in the pericardial space with a bipolar sensing lead on the ventricle and implantation of the device in the abdomen.[36]


Cardiac pacing and defibrillation in children and young adults.

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

Use of an ICD coil in the left axillary vein in a patient with right sided generator implant to lower the DFTs. The atrial lead is in the posterior high right atrial septum near the Bachmann's bundle.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Use of an ICD coil in the left axillary vein in a patient with right sided generator implant to lower the DFTs. The atrial lead is in the posterior high right atrial septum near the Bachmann's bundle.
Mentions: Based on variations in anatomy, the lead implantation technique may have to be revised. In patients with high DFTs at the time of ICD implantation, additional coils or subcutaneous array are implanted.[32] The placement of additional coils can be in the coronary sinus, azygous vein, or the left innominate or axillary vein (Figure 2). Implanting the device in the left axillary region has also been postulated to reduce the DFT.[33] Use of medications like Sotalol has been reported to lower the DFT .[34,35] In some group of patients a 'hybrid' approach to lead implantation is performed. If biventricular pacing is contemplated in patients with d-TGA with atrial switch palliation, a mini-sternotomy or thoracotomy is used to implant the systemic (RV) ventricular epicardial lead that is tunneled to the pocket where the generator with the transvenous leads is placed. In very small patients, ICD is implanted using a pericardial patch or a coil in the pericardial space with a bipolar sensing lead on the ventricle and implantation of the device in the abdomen.[36]

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