JTCS Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Masanobu Maeda
Hajime Sakurai
Akihiko Usui
Yuichi Ueda
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Murayama, H.
Right arrow Articles by Ueda, Y.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Murayama, H.
Right arrow Articles by Ueda, Y.
Related Collections
Right arrow Congenital - cyanotic
Right arrow Electrophysiology - arrhythmias

J Thorac Cardiovasc Surg 2008;135:361-366
© 2008 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Predictors affecting durability of epicardial pacemaker leads in pediatric patients

Hiroomi Murayama, MDa,*, Masanobu Maeda, MDa, Hajime Sakurai, MDa, Akihiko Usui, MDb, Yuichi Ueda, MDb

a Department of Cardiovascular Surgery, Social Insurance Chukyo Hospital, Nagoya, Japan
b Department of Cardio-Thoracic Surgery, Nagoya University, Nagoya, Japan.

Received for publication July 23, 2007; revisions received September 6, 2007; accepted for publication September 13, 2007.

* Address for reprints: Hiroomi Murayama, MD, the Department of Thoracic and Cardiovascular Surgery, Toyohashi Municipal Hospital, Toyohashi, Japan. (Email: romiwo{at}mcn.ne.jp).

Objectives: Despite pacemaker therapy in children and adolescents favoring an initial epicardial approach, predictors of lead failure have not been well clarified. The aim of this study was to assess the long-term outcomes and to determine predictors affecting lead durability in pediatric pacing therapy.

Methods: We reviewed the outcomes of 109 consecutive pacing leads implanted in 55 patients (median age, 5.2 years; range, 31 days–15.8 years), including 38 atrial and 71 ventricular leads. They consisted of 58 (53%) fishhooks, 37 (34%) screw-in leads, and 14 (13%) steroid-eluting suture-on leads. Seventy (64%) were implanted in patients with structural heart disease.

Results: The leads were followed for a median of 6.4 years (range, 3 days–22.9 years). Lead failure occurred in 29 leads (27%; median of 8.4 years after implantation). Exit block or elevation of pacing threshold was the most common cause (n = 18), but failures did not directly cause patient death. The overall 1-, 5-, 10-, and 15-year lead survivals were 100%, 89.0%, 72.5%, and 55.5%, respectively. Multivariate Cox analysis revealed concurrent structural heart disease (relative risk, 2.85; 95% confidence interval, 1.27–6.42; P = .011) to be the only significant predictor of lead failure.

Conclusions: Epicardial leads provide a reliable technique for managing rhythmic disturbance problems in the pediatric population. The only significant predictor of lead failure is the presence of structural heart disease.

Abbreviations and Acronyms S-CHD = structural congenital cardiac disease






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2008 by The American Association for Thoracic Surgery.