The insertion of transvenous pacemakers in chidren is limitated by the calibre of the
upper chest veins and for this reason, many children receive epimyocardial leads.
This article reports a small patient who developed complete atrioventricular block after an
arterial switch operation for transposition of the great arteries.peer-reviewe

Krasemann, T

Rukosujew, A

Scheld, HH

PubMed

Krasemann, Thomas

Rukosujew, A.

Scheld, H.H.

OAR@UM

T Krasemann, A Rukosujew, and HH Scheld. Transvenous pacemaker in a child less than 6 kg. Images Paediatr Cardiol. 2004 Oct-Dec; 6(4): 38–40.   38  IMAGES  in PAEDIATRIC CARDIOLOGY  Images Paediatr Cardiol. 2004 Oct-Dec; 6(4): 38–40.  PMCID: PMC3232528 Transvenous pacemaker in a child less than 6 kg T Krasemann,1 A Rukosujew,2 and HH Scheld2 1University Childrens Hospital Muenster, Dept. Of Pediatric Cardiology. 2University Hospital Muenster, Dept. Of Thoracic and Cardiovascular Surgery. Albert-Schweitzer-str. 33, D-48149 Muenster, Germany. Contact information: Thomas Krasemann, University Childrens Hospital Muenster, Dept. Of Pediatric Cardiology, Albert-Schweitzer-str. 33, D-48149 Muenster, Germany e-mail: kraseman@uni-muenster.de  MeSH: Heart defects, congenital, Cardiac Pacing, Artificial, Transposition of Great Vessels/surgery, Transposition of Great Vessels/complications, Infant Copyright : © Images in Paediatric Cardiology This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.   The insertion of transvenous pacemakers in chidren is limitated by the calibre of the upper chest veins and for this reason, many children receive epimyocardial leads.1 We report a small patient who developed complete atrioventricular block after an arterial switch operation for transposition of the great arteries. He had a resting ventricular rate of less than 50 bpm. Initially he received an epimyocardial pacemaker with frequencies of 100 bpm. The child was clinnically well and gained weight. Six weeks after implantation the mother noted bradycardia, which was caused by high threshold followed by an exit block due to scarring. The child's weight had reached 5.9 kg. Intraoperatively, no reliable lead position could be found due to scarring with high electrical resistance and for this reason, endomyocardial leads (Medtronic 5076) were implanted through a transvenous approach. The leads were positioned through the left subclavian vein. A subpectoral pocket was created for the pulse generator (Medtronic Kappa KSR 901). The pacemaker functions well since one year and on ultasonography, the innominate and upper caval veins reveal discrete flow acceleration. Comment: When scarring only permits the use of epimyocardial pacemaker leads, a transvenous approach can be used with good results even in small children.2 In our institution this child weighing less than 6 kg is the smallest one treated with this technique. T Krasemann, A Rukosujew, and HH Scheld. Transvenous pacemaker in a child less than 6 kg. Images Paediatr Cardiol. 2004 Oct-Dec; 6(4): 38–40.   39 Fig. 1 Clinical aspect of the subpectoral pulse generator   Fig. 2 Chest X-ray demonstrating the position of the leads   T Krasemann, A Rukosujew, and HH Scheld. Transvenous pacemaker in a child less than 6 kg. Images Paediatr Cardiol. 2004 Oct-Dec; 6(4): 38–40.   40 References 1. Sachweh JS, Vasquez-Jiminez JF, Schondube FA, Daebritz SH, Dorge H, Muhler EG, Messmer BJ. Twenty years experience with pediatric pacing: epimyocardial and transvenous stimulation. Eur J Cardiothorac Surg. 2000;17:455–461.[PubMed: 10773570] 2. Molina JE, Dunnigan AC, Crosson JE. Implantation of transvenous pacemakers in infants and small children. Ann Thorac Surg. 1995;59:689–694.[PubMed: 7887713]  © Images in Paediatric Cardiology (1999-2012)   

English

1 Clinical aspect of the subpectoral pulse generator Fig. 2 Chest X-ray demonstrating the position of the leads T Krasemann, A Rukosujew, and HH Scheld. Transvenous pacemaker in a child less than 6 kg. Images Paediatr Cardiol.

Implantation of transvenous pacemakers in infants and small children. Ann Thorac Surg.

Twenty years experience with pediatric pacing: epimyocardial and transvenous stimulation.

Transvenous pacemaker in a child less than 6 kg

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3232528

Transvenous pacemaker in a child less than 6 kg

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