An epicardial pacing safety net

An alternative technique for pacing in the young

Scott R. Ceresnak, Leonardo Liberman, Jonathan M. Chen, Allan J. Hordof, John J. Lamberti, William J. Bonney, Robert H. Pass

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Epicardial pacing is the standard approach for permanent pacing in small children and patients with functionally univentricular physiology. The longevity of epicardial leads, however, is compromised by increased occurrences of exit block and lead fractures. We report our experience with a technique of placing a second ventricular lead, and attaching it to the atrial port of a dual chamber pacemaker to prevent the need for early re-operation in the event of failure of the primary epicardial lead. A retrospective review showed that, over the period from 2001 through 2007, epicardial ventricular pacemakers had been placed in 88 patients. In 6 of these, we had placed 2 ventricular leads, their median weight being 8.0 kilograms, with a range from 4.2 to 31.8 kilograms. Fracture of a lead occurred in 1 of the patients (17%) 8 months after placement, requiring reprogramming to pace from the atrial port. This possibility avoided the need for repeated emergent surgery. At a median follow-up of 1.5 years, with a range from 0.3 to 4.4 years, there have been no complications. During the same time period, overall failure of epicardial leads at our institution was 13%. Placement of a second ventricular epicardial pacing lead, attached to the atrial port of a dual chamber pacemaker, therefore, may provide a safe and effective means of ventricular pacing in the setting of epicardial lead failure, and may obviate the need for repeat, potentially urgent, pacemaker surgery.

Original languageEnglish (US)
Pages (from-to)228-232
Number of pages5
JournalCardiology in the Young
Volume19
Issue number3
DOIs
StatePublished - 2009

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Keywords

  • Arrhythmia
  • Pacemaker
  • Paediatrics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Ceresnak, S. R., Liberman, L., Chen, J. M., Hordof, A. J., Lamberti, J. J., Bonney, W. J., & Pass, R. H. (2009). An epicardial pacing safety net: An alternative technique for pacing in the young. Cardiology in the Young, 19(3), 228-232. https://doi.org/10.1017/S1047951109003710

An epicardial pacing safety net : An alternative technique for pacing in the young. / Ceresnak, Scott R.; Liberman, Leonardo; Chen, Jonathan M.; Hordof, Allan J.; Lamberti, John J.; Bonney, William J.; Pass, Robert H.

In: Cardiology in the Young, Vol. 19, No. 3, 2009, p. 228-232.

Research output: Contribution to journalArticle

Ceresnak, SR, Liberman, L, Chen, JM, Hordof, AJ, Lamberti, JJ, Bonney, WJ & Pass, RH 2009, 'An epicardial pacing safety net: An alternative technique for pacing in the young', Cardiology in the Young, vol. 19, no. 3, pp. 228-232. https://doi.org/10.1017/S1047951109003710
Ceresnak SR, Liberman L, Chen JM, Hordof AJ, Lamberti JJ, Bonney WJ et al. An epicardial pacing safety net: An alternative technique for pacing in the young. Cardiology in the Young. 2009;19(3):228-232. https://doi.org/10.1017/S1047951109003710
Ceresnak, Scott R. ; Liberman, Leonardo ; Chen, Jonathan M. ; Hordof, Allan J. ; Lamberti, John J. ; Bonney, William J. ; Pass, Robert H. / An epicardial pacing safety net : An alternative technique for pacing in the young. In: Cardiology in the Young. 2009 ; Vol. 19, No. 3. pp. 228-232.
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