Abstract
AimsAtrial leads are often implanted in paediatric patients needing a pacemaker (PM). The aim of this study is the evaluation of their outcome in young patients.Methods and resultsWe evaluated transvenous atrial leads outcome in children and young adults from a single centre, with a retrospective analysis. A P<0.05 was considered significant. Between 1992 and 2008, 110 patients, 75 with congenital heart defects (d-transposition of great arteries status/post, s/p, Mustard 41, atrioventricular septal defect 11, tetralogy 9, ventricular septal defect 8), aged 13.3 ± 5.3 years, underwent PM implantation with bipolar atrial transvenous leads for sinus node dysfunction (50), atrioventricular block (38), cardiomyopathies, and primary ventricular arrhythmias (12). Leads are steroid-eluting (98), tined (59), screw-in (41), polyurethane-insulated (72), silicone-insulated (28), and have been positioned by transcutaneous puncture of subclavian vein into right atrial appendage/remnant (RAA, 50), right atrial free wall/septum (25), left atrium (s/p Mustard, 25). Follow-up duration is 6.4 ± 4.8 (range 0.118) years. At multivariate analysis, younger age at implant was a risk factor for lead failure (4 leads, 3.5) (P 0.03); 16 leads (14) dislodged post-implantation and 12 were successfully repositioned, the others extracted or abandoned. Dislocation occurred more frequently with screw-in leads (P 0.03) positioned outside RAA (P 0.02). Atrial threshold showed a small but significant increase, 0.002 V/month (P<0.001), impedance showed a decrease (0.6 Ω/month, P<0.001), P-wave showed no significant difference.ConclusionsTransvenous bipolar atrial leads have good long-term results in young patients, with a very low rate of lead failure. Older age at implant can further reduce this rate. Lead dislodgement is frequent in the post-operative period. Published on behalf of the European Society of Cardiology. All rights reserved.
| Original language | English |
|---|---|
| Pages (from-to) | 1002-1007 |
| Number of pages | 6 |
| Journal | Europace |
| Volume | 14 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jul 2012 |
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Keywords
- Cardiac pacing
- Children
- Endocardial pacing
- Pacemaker
- Pacing complications
- Pacing leads
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
Long-term outcome of transvenous bipolar atrial leads implanted in children and young adults with congenital heart disease. / Silvetti, Massimo Stefano; Drago, Fabrizio; Rav, Lucilla.
In: Europace, Vol. 14, No. 7, 07.2012, p. 1002-1007.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term outcome of transvenous bipolar atrial leads implanted in children and young adults with congenital heart disease
AU - Silvetti, Massimo Stefano
AU - Drago, Fabrizio
AU - Rav, Lucilla
PY - 2012/7
Y1 - 2012/7
N2 - AimsAtrial leads are often implanted in paediatric patients needing a pacemaker (PM). The aim of this study is the evaluation of their outcome in young patients.Methods and resultsWe evaluated transvenous atrial leads outcome in children and young adults from a single centre, with a retrospective analysis. A P<0.05 was considered significant. Between 1992 and 2008, 110 patients, 75 with congenital heart defects (d-transposition of great arteries status/post, s/p, Mustard 41, atrioventricular septal defect 11, tetralogy 9, ventricular septal defect 8), aged 13.3 ± 5.3 years, underwent PM implantation with bipolar atrial transvenous leads for sinus node dysfunction (50), atrioventricular block (38), cardiomyopathies, and primary ventricular arrhythmias (12). Leads are steroid-eluting (98), tined (59), screw-in (41), polyurethane-insulated (72), silicone-insulated (28), and have been positioned by transcutaneous puncture of subclavian vein into right atrial appendage/remnant (RAA, 50), right atrial free wall/septum (25), left atrium (s/p Mustard, 25). Follow-up duration is 6.4 ± 4.8 (range 0.118) years. At multivariate analysis, younger age at implant was a risk factor for lead failure (4 leads, 3.5) (P 0.03); 16 leads (14) dislodged post-implantation and 12 were successfully repositioned, the others extracted or abandoned. Dislocation occurred more frequently with screw-in leads (P 0.03) positioned outside RAA (P 0.02). Atrial threshold showed a small but significant increase, 0.002 V/month (P<0.001), impedance showed a decrease (0.6 Ω/month, P<0.001), P-wave showed no significant difference.ConclusionsTransvenous bipolar atrial leads have good long-term results in young patients, with a very low rate of lead failure. Older age at implant can further reduce this rate. Lead dislodgement is frequent in the post-operative period. Published on behalf of the European Society of Cardiology. All rights reserved.
AB - AimsAtrial leads are often implanted in paediatric patients needing a pacemaker (PM). The aim of this study is the evaluation of their outcome in young patients.Methods and resultsWe evaluated transvenous atrial leads outcome in children and young adults from a single centre, with a retrospective analysis. A P<0.05 was considered significant. Between 1992 and 2008, 110 patients, 75 with congenital heart defects (d-transposition of great arteries status/post, s/p, Mustard 41, atrioventricular septal defect 11, tetralogy 9, ventricular septal defect 8), aged 13.3 ± 5.3 years, underwent PM implantation with bipolar atrial transvenous leads for sinus node dysfunction (50), atrioventricular block (38), cardiomyopathies, and primary ventricular arrhythmias (12). Leads are steroid-eluting (98), tined (59), screw-in (41), polyurethane-insulated (72), silicone-insulated (28), and have been positioned by transcutaneous puncture of subclavian vein into right atrial appendage/remnant (RAA, 50), right atrial free wall/septum (25), left atrium (s/p Mustard, 25). Follow-up duration is 6.4 ± 4.8 (range 0.118) years. At multivariate analysis, younger age at implant was a risk factor for lead failure (4 leads, 3.5) (P 0.03); 16 leads (14) dislodged post-implantation and 12 were successfully repositioned, the others extracted or abandoned. Dislocation occurred more frequently with screw-in leads (P 0.03) positioned outside RAA (P 0.02). Atrial threshold showed a small but significant increase, 0.002 V/month (P<0.001), impedance showed a decrease (0.6 Ω/month, P<0.001), P-wave showed no significant difference.ConclusionsTransvenous bipolar atrial leads have good long-term results in young patients, with a very low rate of lead failure. Older age at implant can further reduce this rate. Lead dislodgement is frequent in the post-operative period. Published on behalf of the European Society of Cardiology. All rights reserved.
KW - Cardiac pacing
KW - Children
KW - Endocardial pacing
KW - Pacemaker
KW - Pacing complications
KW - Pacing leads
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UR - http://www.scopus.com/inward/citedby.url?scp=84863005713&partnerID=8YFLogxK
U2 - 10.1093/europace/eus024
DO - 10.1093/europace/eus024
M3 - Article
C2 - 22379180
AN - SCOPUS:84863005713
VL - 14
SP - 1002
EP - 1007
JO - Europace
JF - Europace
SN - 1099-5129
IS - 7
ER -