Zartner Peter A
Abteilung für Kinderkardiologie, Kinderherzzentrum am Universitätsklinikum Bonn, Campus Venusberg 1, 53127, Bonn, Deutschland.
Herzschrittmacherther Elektrophysiol. 2025 Jun;36(2):119-125. doi: 10.1007/s00399-025-01080-y. Epub 2025 May 21.
Patients with congenital heart defects have an increased indication rate for pacemaker systems and implantable cardioverter defibrillators (ICD), which however are not designed for children. Therefore, the combination of selected materials is essential for long-term and safe therapy. Epimyocardial systems are the best option for neonates and infants, as well as patients with Fontan circulation who do not have systemic venous access to the heart. For most other patients, transvenous systems are advantageous because the leads and batteries last longer and are easier to adjust as the patient grows. To avoid vascular complications, only the thinnest leads should be used and broken leads should be explanted. Telemetric monitoring is urgently indicated for these patients in order to detect rhythm or system disturbances at an early stage.
先天性心脏缺陷患者对起搏器系统和植入式心脏复律除颤器（ICD）的适应证率有所增加，然而这些设备并非为儿童设计。因此，选择合适的材料组合对于长期安全治疗至关重要。心外膜系统是新生儿、婴儿以及没有体静脉与心脏连接的Fontan循环患者的最佳选择。对于大多数其他患者，经静脉系统更具优势，因为电极导线和电池使用寿命更长，并且随着患者成长更易于调整。为避免血管并发症，应仅使用最细的电极导线，断裂的电极导线应予以取出。对于这些患者，迫切需要进行遥测监测，以便早期发现节律或系统紊乱。
