z-logo
Premium
Transvenous Pacing in Children Weighing Less than 10 Kilograms
Author(s) -
ROBLEDONOLASCO ROGELIO,
ORTIZAVALOS MARTÍN,
RODRIGUEZDIEZ GERARDO,
JIMENEZCARRILLO CESAR,
RAMÍREZMACHUCA JORGE,
DE HARO SERGIO,
CASTROVILLACORTA HUMBERTO
Publication year - 2009
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2008.02276.x
Subject(s) - medicine , atrioventricular block , surgery , transvenous pacing , heart block , subclavian vein , sick sinus syndrome , cephalic vein , bradycardia , thrombosis , cardiac pacing , cardiology , vein , electrocardiography , catheter , heart rate , blood pressure
Pacemakers are used in small children with increasing frequency for the treatment of life‐threatening bradyarrhythmias. The epicardial approach is generally preferred in these patients, to avoid the risks of vessel thrombosis. We examined the feasibility and safety of transvenous pacemaker implantation in children weighing <10 kg, via subclavian puncture, using a 4 Fr sheath introduced after a venogram was performed to evaluate the vein diameter. Progressive dilation with 5, 6, and 7 Fr sheaths preceded the insertion and placement of the endocardial lead. A subaponeurotic pocket was created in the abdominal or pectoral regions, depending upon the patient's size. Between 2001 and 2007, we treated 12 patients (median age = 16 months; range 1–32; median weight = 7.9 kg; range 2.3–10.0; 7 males), of whom four weighed <5 kg. Indications for permanent pacing included postsurgical complete atrioventricular block (n = 8), sinus node dysfunction (n = 2), congenital atrioventricular block (n = 1), and long QT syndrome (n = 1). Single‐chamber pacemakers were implanted in 10, and dual‐chamber pacemakers in two patients. The patients were evaluated at 48 hours, 10 days, and at 3 and 6 months. The mean follow‐up was 31.8 ± 23.5 months. There were no procedural complications. Lead dislodgment occurred in one patient and required replacement of the ventricular lead. One patient died from septicemia. Endocardial pacemaker implantation was feasible and safe in children weighing <10 kg. This procedure is less invasive than the standard epicardial approach.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here