L'impianto di pacemaker nel bambino: Una terapia o un meccanismo patogenetico per la disfunzione ventricolare?

Translated title of the contribution: Pacemaker implantation in children: Is this a therapy or a pathogenetic mechanism for ventricular dysfunction?

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1 Citation (Scopus)

Abstract

Ventricular pacing, typically initiated from a right ventricular apical electrode, inherently causes abnormal biventricular activation, decreases left ventricular function, and may cause histopathological changes. Data regarding cardiac resynchronization therapy in pediatric patients are limited. Some authors evaluated the potential of improving paced left ventricular function by a septal electrode implant site. For this reason the role of pacing is not clear in children. In isolated congenital atrioventricular block, cardiac pacing represents a satisfactory treatment. However, recent evidence has demonstrated that a subset of patients with isolated congenital complete atrioventricular block develops dilated cardiomyopathy. Patients with congenital heart diseases after surgery represent a unique and expanding population. Some will require pacemaker or implantable defibrillator therapy. They pose technical and management challenges not encountered in other groups receiving pacing, and the complication and reintervention rates specific to this population are not well defined. Moreover, the small patient size, structural cardiac abnormalities, and growth may complicate pediatric pacemaker management. Better knowledge of risk factors for lead failure in these patients may help improve future outcomes. In this review we analyzed many of these problems.

Original languageItalian
Pages (from-to)612-617
Number of pages6
JournalGiornale Italiano di Cardiologia
Volume7
Issue number9
Publication statusPublished - Sep 2006

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Ventricular Dysfunction
Atrioventricular Block
Left Ventricular Function
Electrodes
Pediatrics
Therapeutics
Cardiac Resynchronization Therapy
Implantable Defibrillators
Dilated Cardiomyopathy
Population
Heart Diseases
Growth

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "L'impianto di pacemaker nel bambino: Una terapia o un meccanismo patogenetico per la disfunzione ventricolare?",
abstract = "Ventricular pacing, typically initiated from a right ventricular apical electrode, inherently causes abnormal biventricular activation, decreases left ventricular function, and may cause histopathological changes. Data regarding cardiac resynchronization therapy in pediatric patients are limited. Some authors evaluated the potential of improving paced left ventricular function by a septal electrode implant site. For this reason the role of pacing is not clear in children. In isolated congenital atrioventricular block, cardiac pacing represents a satisfactory treatment. However, recent evidence has demonstrated that a subset of patients with isolated congenital complete atrioventricular block develops dilated cardiomyopathy. Patients with congenital heart diseases after surgery represent a unique and expanding population. Some will require pacemaker or implantable defibrillator therapy. They pose technical and management challenges not encountered in other groups receiving pacing, and the complication and reintervention rates specific to this population are not well defined. Moreover, the small patient size, structural cardiac abnormalities, and growth may complicate pediatric pacemaker management. Better knowledge of risk factors for lead failure in these patients may help improve future outcomes. In this review we analyzed many of these problems.",
keywords = "Atrioventricular block, Cardiac pacing, Cardiac resynchronization therapy, Congenital heart defects, Pediatric patients",
author = "Giovanni Fazio and Silvetti, {Massimo Stefano} and Fabrizio Drago",
year = "2006",
month = "9",
language = "Italian",
volume = "7",
pages = "612--617",
journal = "Giornale Italiano di Cardiologia",
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AU - Silvetti, Massimo Stefano

AU - Drago, Fabrizio

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N2 - Ventricular pacing, typically initiated from a right ventricular apical electrode, inherently causes abnormal biventricular activation, decreases left ventricular function, and may cause histopathological changes. Data regarding cardiac resynchronization therapy in pediatric patients are limited. Some authors evaluated the potential of improving paced left ventricular function by a septal electrode implant site. For this reason the role of pacing is not clear in children. In isolated congenital atrioventricular block, cardiac pacing represents a satisfactory treatment. However, recent evidence has demonstrated that a subset of patients with isolated congenital complete atrioventricular block develops dilated cardiomyopathy. Patients with congenital heart diseases after surgery represent a unique and expanding population. Some will require pacemaker or implantable defibrillator therapy. They pose technical and management challenges not encountered in other groups receiving pacing, and the complication and reintervention rates specific to this population are not well defined. Moreover, the small patient size, structural cardiac abnormalities, and growth may complicate pediatric pacemaker management. Better knowledge of risk factors for lead failure in these patients may help improve future outcomes. In this review we analyzed many of these problems.

AB - Ventricular pacing, typically initiated from a right ventricular apical electrode, inherently causes abnormal biventricular activation, decreases left ventricular function, and may cause histopathological changes. Data regarding cardiac resynchronization therapy in pediatric patients are limited. Some authors evaluated the potential of improving paced left ventricular function by a septal electrode implant site. For this reason the role of pacing is not clear in children. In isolated congenital atrioventricular block, cardiac pacing represents a satisfactory treatment. However, recent evidence has demonstrated that a subset of patients with isolated congenital complete atrioventricular block develops dilated cardiomyopathy. Patients with congenital heart diseases after surgery represent a unique and expanding population. Some will require pacemaker or implantable defibrillator therapy. They pose technical and management challenges not encountered in other groups receiving pacing, and the complication and reintervention rates specific to this population are not well defined. Moreover, the small patient size, structural cardiac abnormalities, and growth may complicate pediatric pacemaker management. Better knowledge of risk factors for lead failure in these patients may help improve future outcomes. In this review we analyzed many of these problems.

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KW - Congenital heart defects

KW - Pediatric patients

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