SPC365

Pediatric cardiac pacing: twenty years of a single-centre experience

Session: Posters (Sessão 4 - Écran 1) - Dispositivos em Arritmologia
Speaker: Diana Vale Carvalho

Congress: CPC 2023
Topic: C. Arrhythmias and Device Therapy
Theme: 09. Device Therapy
Subtheme: 09.6 Device Therapy - Other
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Diana Vale Carvalho; Helena Andrade; Isabel Santos; Raquel Ferreira; Mesquita Bastos; António Pires
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Background</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">Permanent pacing at pediatric age is conditioned by some biological factors such as growth, limited vascular access and possibly complex congenital heart diseases. There are few studies on definitive pacemaker implantation in children, usually with a small number of patients.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Purpose</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">The objective of this study was to characterize the population of patients who was submitted to permanent pacemaker implantation in pediatric age. It also intends to assess which factors are associated with the occurrence of clinical outcomes in the follow-up.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Methods</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">Retrospective study including pediatric patients undergoing definitive pacemaker implantation. </span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Results</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">34 patients were included (61.8% female). The mean age at diagnosis was 1,5 &plusmn; 2,8Y and the mean age at pacemaker implantation was 5,9 &plusmn; 6,1Y. Auriculoventricular node disease AV was the most frequent, with predominance of complete AV block (85%). There was a slight predominance of endocardial electrodes (53%). Pacing modes VVI/R and DDD/R were the most used (41% and 53%, respectively). In most patients, no underlying pathology was documented that justified the conduction disease, and these conduction disorders were classified as idiopathic (44%). Complete AV block after cardiac surgery due to structural disease justified 38% of the implantations. Implantation of epicardial electrodes occurred at younger ages, compared to endocardial (30.9 42.2 vs 128.9 65.0 months, p&lt;0.001). Univariate analysis showed that patients with epicardial electrode presented higher ventricular thresholds at implantation (p=0.038) and at the last follow-up visit (p=0.004). However, there was no statistically significant difference between the number of generator replacements in both groups (p=0.206). In the univariate analysis, there was no statistically significant association between the location of the electrode (epicardial/endocardial) and the occurrence of any complication [(early/late) (p=0.833)]. The same occurred when considering only the displacement of electrodes (p=0,25). Considering the event-free survival curves, there were no statistically significant differences between the location of the electrode (epicardial/endocardial).</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Conclusions</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">Permanent pacemaker implantation is relatively safe in pediatric age. However, there is a significant number of complications mainly related to the lead. Epicardial leads are associated with higher ventricular thresholds. There is no difference in event-free survival (epicardial/endocardial).</span></span></span></p>