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Ann Thorac Surg 1978;25:144-147
© 1978 The Society of Thoracic Surgeons

Articles

Fourteen Years of Implanted Pacemakers in Children

Robert P.N. Shearin, M.D., William H. Fleming, M.D.*

Joseph B. Whitehead Department of Surgery, Division of Thoracic and Cardiovascular Surgery, Emory University School of Medicine, Atlanta, GA.

Accepted for publication June 7, 1977.

* Address reprint requests to Dr. Fleming, Department of Surgery (Thoracic), University of Nebraska Medical Center, 42nd St and Dewey Ave, Omaha, NB 68105

Twenty-six children who had permanent pacemakers implanted at 6 hours to 11 years of age have been followed for up to 163 months. There were 14 children with surgical heart block, 9 with congenital heart block, 2 with postcatheterization complete heart block, and 1 with bradytachydysrhythmia syndrome. Eighteen of the 26 patients (69%) are still being paced with their original electrodes, some for more than eight years. Sixty pulse generators lasted an average of 17 months (range, 1 to 55 months).

Five of the 26 patients (19%) are dead. Three died of noncorrectable heart disease, but there were 2 sudden unexplained deaths at home, both apparently due to sudden arrhythmias. Both of these patients had received fixed-rate pulse generators, and 1 had a known potential for competing rhythms.

The current optimal choices of equipment and techniques, including the role of synchronized, demand, lithium-powered, and nuclear-powered pulse generators, are discussed.




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