The Annals of Thoracic Surgery, Vol 31, 329-333, Copyright © 1981 by The Society of Thoracic Surgeons
Changing indications for pacemakers in children
WH Fleming, LB Sarafian, JD Kugler, PJ Hofschire and EB Clark
Permanent pacemakers were implanted in 50 children. Indications were
symptomatic sinus node dysfunction in 34 (68%), surgical block in 9 (18%),
and congenital block in 7 (14%). Twenty-three (68%) of the 34 children with
sinus node dysfunction had undergone prior cardiac operations. Only 4 of
the 50 patients (8%) had electrode problems after a mean pacing time of
29.5 months (range, 1 to 96 months). All 35 of the mercury-cell pulse
generators used in 28 patients ceased to function after an average useful
life of 20.8 months (range, 1 to 51 months). The lithium-powered units in
the 45 survivors all show satisfactory pacing after 5 to 44 months (mean,
28.1 months). With improved pacemaker technology, longer survival after
complex repairs, and better monitoring techniques, the indications for
cardiac pacing in children have broadened. Surgical block now is an
indication in only a small fraction of the pediatric pacemaker population.
Sinus node dysfunction accounts for an ever-increasing majority of the
pacemakers we currently implant in children.
