Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Hospital, Theodor-Stern-Kai 7, 60596 Frankfurt/Main, Germany.
Europace. 2010 Apr;12(4):540-3. doi: 10.1093/europace/euq037. Epub 2010 Feb 25.
The purpose of this paper is the retrospective investigation of the clinical outcome and modes of failure leading to reoperation, as well as the report of the long-term results, in a group of young children who underwent epicardial pacemaker implantation.
Between 2000 and 2008, 45 young children underwent epicardial pacemaker implantation at 3.2 +/- 2.5 years of age for congenital (n = 27) or post-operative (n = 18) atrioventricular block. The follow-up time was 5.7 years +/- 5 months (range: 6 months to 7.3 years). Five lead malfunction events (11%) were detected during the follow-up time, three of which were due to ventricular lead fracture. All revisions could be performed without complications, and all revised pacemakers showed stable pacing and sensing parameters during long-term follow-up. The actuarial freedom from reoperation at 6 years was 88.8 +/- 2%. Median epicardial ventricular and atrial pacing thresholds were stable and excellent at the latest follow-up, with means of 1.1 +/- 0.5 V and 0.7 +/- 0.8 V, respectively.
In our patient cohort of 45 young children, epicardial pacing was associated with a satisfactory clinical outcome and acceptable long-term results. The major cause of reoperation in our series was lead fracture. Reoperations were performed at a low risk.
本文旨在回顾性研究一组接受心外膜起搏器植入的幼儿的临床结果和导致再次手术的失败模式，并报告长期结果。
2000 年至 2008 年间，45 名幼儿因先天性（n=27）或术后（n=18）房室传导阻滞在 3.2±2.5 岁时接受心外膜起搏器植入。随访时间为 5.7 年±5 个月（范围：6 个月至 7.3 年）。在随访期间检测到 5 次导联故障事件（11%），其中 3 次是由于心室导联断裂。所有修复都可以在没有并发症的情况下进行，所有修复后的起搏器在长期随访中均显示稳定的起搏和感知参数。6 年时免于再次手术的累积生存率为 88.8%±2%。在最近的随访中，心外膜心室和心房起搏阈值稳定且良好，平均值分别为 1.1±0.5V 和 0.7±0.8V。
在我们的 45 名幼儿患者队列中，心外膜起搏与令人满意的临床结果和可接受的长期结果相关。本系列中再次手术的主要原因是导联断裂。再次手术的风险较低。
