What Are Indications for Pediatric Pacemakers?
Discussion
More pediatric patients are having cardiac pacemakers and implantable cardioverter defibrillators (ICDs) placed because the devices are becoming smaller and are technically feasible plus the surgical complexity of patients also keeps increasing. Pacemakers have an impulse generator and leads. The leads can be placed uni- or bilaterally and are attached to the endo- or epicardium. The generator is placed in the left pectoral area. Complications include lead dislodgement or breakage, and inappropriate shocks. Other problems include need for lead or generator revisions, lifestyle modifications, and cosmetic changes. ICDs are like pacemakers but can also defibrillate tachyarrhythmias.
Patients and families of children with pacemakers and ICDs demonstrated decreased quality of life scores compared to healthy controls and also patients with congenital heart disease (CHD) without the devices. For patients with pacemakers, self-perception is the main element in the lower quality of life.
Learning Point
Indications for pacemaker implantation from the American Heart Association:
“
Class I – Pacemaker implantation indicated
Advanced second/third-degree AV block with symptomatic bradycardia, ventricular dysfunction, or low cardiac outputs or that persists at least 7 days postcardiac surgery
Symptomatic age-inappropriate sinus bradycardia
Congenital third-degree AV block with wide QRS, complex ventricular ectopy, or ventricular dysfunction
Congenital third-degree ...
Source: PediatricEducation.org - Category: Pediatrics Authors: Donna M. D'Alessandro, M.D. Tags: Uncategorized Source Type: news
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