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Janoušek, J; van Geldorp, IE; Krupičková, S; Rosenthal, E; Nugent, K; Tomaske, M; Früh, A; Elders, J; Hiippala, A; Kerst, G; Gebauer, RA; Kubuš, P; Frias, P; Gabbarini, F; Clur, SA; Nagel, B; Ganame, J; Papagiannis, J; Marek, J; Tisma-Dupanovic, S; Tsao, S; Nürnberg, JH; Wren, C; Friedberg, M; de Guillebon, M; Volaufova, J; Prinzen, FW; Delhaas, T; Working Group for Cardiac Dysrhythmias and Electrophysiology of the Association for European Pediatric Cardiology.
Permanent cardiac pacing in children: choosing the optimal pacing site: a multicenter study.
Circulation. 2013; 127(5):613-623 Doi: 10.1161/CIRCULATIONAHA.112.115428 [OPEN ACCESS]
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Co-authors Med Uni Graz: Nagel Bert Hermann Philipp
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Abstract:: Background-We evaluated the effects of the site of ventricular pacing on left ventricular (LV) synchrony and function in children requiring permanent pacing. Methods and Results-One hundred seventy-eight children (aged < 18 years) from 21 centers with atrioventricular block and a structurally normal heart undergoing permanent pacing were studied cross-sectionally. Median age at evaluation was 11.2 (interquartile range, 6.3-15.0) years. Median pacing duration was 5.4 (interquartile range, 3.1-8.8) years. Pacing sites were the free wall of the right ventricular (RV) outflow tract (n=8), lateral RV (n=44), RV apex (n=61), RV septum (n=29), LV apex (n=12), LV midlateral wall (n=17), and LV base (n=7). LV synchrony, pump function, and contraction efficiency were significantly affected by pacing site and were superior in children paced at the LV apex/LV midlateral wall. LV dyssynchrony correlated inversely with LV ejection fraction (R=0.80, P=0.031). Pacing from the RV outflow tract/lateral RV predicted significantly decreased LV function (LV ejection fraction < 45%; odds ratio, 10.72; confidence interval, 2.07-55.60; P=0.005), whereas LV apex/LV midlateral wall pacing was associated with preserved LV function (LV ejection fraction >= 55%; odds ratio, 8.26; confidence interval, 1.46-47.62; P=0.018). Presence of maternal autoantibodies, gender, age at implantation, duration of pacing, DDD mode, and QRS duration had no significant impact on LV ejection fraction. Conclusions-The site of ventricular pacing has a major impact on LV mechanical synchrony, efficiency, and pump function in children who require lifelong pacing. Of the sites studied, LV apex/LV midlateral wall pacing has the greatest potential to prevent pacing-induced reduction of cardiac pump function. (Circulation. 2013;127:613-623.)
Find related publications in this database (using NLM MeSH Indexing): Adolescent -; Atrioventricular Block - pathology; Cardiac Pacing, Artificial - methods; Child -; Cross-Sectional Studies -; Electrocardiography -; Female -; Heart Ventricles - pathology; Humans -; Male -; Models, Cardiovascular -; Pacemaker, Artificial -; Radiography, Thoracic -; Retrospective Studies -; Stroke Volume - physiology; Ventricular Dysfunction, Left - physiopathology
Find related publications in this database (Keywords): heart block; heart failure; pacemakers; pacing; pediatrics