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Pacemaker Implantation in Neonates and Infants: Favorable Outcomes with Epicardial Pacing Systems

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Abstract

The implantation of pacemakers (PM) in neonates and infants requires particular consideration of small body size, marked body growth potential, and the decades of future pacing therapy to be expected. The aim of this study is to quantify the complications of implantation and outcome occurring at our center and to compare these with other centers. Retrospective analysis of 52 consecutive patients undergoing PM implantation at a single tertiary care center within the first year of life. PMs were implanted at a median age of 3 months (range 0–10 months). Structural heart defects were present in 44 of 52 patients. During a median follow-up time of 40.4 months (range 0.1–114 months), measurements for sensing, pacing thresholds, and lead impedance remained stable. No adverse pacing effect was observed in left ventricular function or dimensions over time. There were 20 reoperations in 13 patients at a median time of 4.7 years (range 0.05–8.2 years) after implantation, for end of battery life (n = 10), lead dysfunction (n = 3), device dislocation (n = 3), infection (n = 3), and diaphragmatic paresis (n = 1). No PM-related mortality occurred. Epicardial pacemaker implantation in neonates and infants is an invasive but safe and effective procedure with a relatively low risk of complications. Our current implantation technique and the use of bipolar steroid-eluting electrodes, which we prefer to implant on the left ventricular apex, lead to favorable long-term results.

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Authors and Affiliations

  1. Department of Surgery, Pediatric Cardiology, Pediatric Heart Center, University Children’s Hospital, Steinweisstrasse 75, 8032, Zurich, Switzerland

    Marc Wildbolz, Roland Weber, Matthias Gass & Christian Balmer

  2. Department of Surgery, Pediatric Cardiovascular Surgery, Pediatric Heart Center, University Children’s Hospital, Zurich, Switzerland

    Hitendu Dave

  3. Children’s Research Center, University Children’s Hospital, Zurich, Switzerland

    Marc Wildbolz, Hitendu Dave, Roland Weber, Matthias Gass & Christian Balmer

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  1. Marc Wildbolz
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  2. Hitendu Dave
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  4. Matthias Gass
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  5. Christian Balmer
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Correspondence to Christian Balmer.

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Wildbolz, M., Dave, H., Weber, R. et al. Pacemaker Implantation in Neonates and Infants: Favorable Outcomes with Epicardial Pacing Systems. Pediatr Cardiol 41, 910–917 (2020). https://doi.org/10.1007/s00246-020-02332-z

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  • DOI: https://doi.org/10.1007/s00246-020-02332-z

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