科研之友
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摘要
Background. Because of small size and anatomic variation, implantation of intracardiac leads for permanent pacing in pediatric and congenital heart disease (CHD) patients can be challenging. A novel 4.1F bipolar catheter-delivered lead offers potential advantages for this population. Objective. The purpose of this study was to retrospectively evaluate this lead performance in this specific population. Methods. We performed a retrospective descriptive analysis of all pediatric and adult CHD patients at a single center implanted with a 4.1F bipolar catheter-delivered active fixation pacemaker lead (Medtronic model 3830, Medtronic, Inc, Minneapolis, MN, USA). Results. Over 10 months, 42 leads were implanted in 27 patients. Twenty-six atrial and 16 ventricular leads were placed. Patient ages were 1-28 years (mean 15 +/- 7), and weights were 7.8-104 kg (mean 51.5 +/- 26.6). Ventricular septal defect and D-transposition of great arteries were the most prevalent CHD diagnoses. Implant capture thresholds were 1.2 +/- 0.8 V at 0.5 ms in the atrium and 0.8 +/- 0.5 V at 0.5 ms in the ventricle. Implant sensing thresholds were 4.1 +/- 2.7 mV in the atrium and 12.1 +/- 4.9 mV in the ventricle. Phrenic nerve stimulation was avoided in all, and selective site pacing was achieved in most cases. Pacing and sensing thresholds remained stable during 90 +/- 52 days follow-up. No lead related complications, failures, or extractions were observed. Conclusions. In our single-center experience with pediatric and CHD patients, a novel small, catheter-delivered bipolar lead has proven safe and effective for atrial and ventricular pacing in acute and subacute time periods. Longer performance trends will be required to determine chronic efficacy.
- 出版日期2010-4
