Epicardial Pacemaker

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Wilson Lam - One of the best experts on this subject based on the ideXlab platform.

Angeline Opina - One of the best experts on this subject based on the ideXlab platform.

Wayne H Franklin - One of the best experts on this subject based on the ideXlab platform.

  • dual chamber Epicardial pacing in neonates with congenital heart block
    The Journal of Thoracic and Cardiovascular Surgery, 2007
    Co-Authors: Angela M Kelle, Carl L Backer, Sabrina Tsao, Robert D Stewart, Wayne H Franklin
    Abstract:

    Objective This review evaluates the outcome of a treatment strategy using dual-chamber Pacemakers for neonates with congenital heart block. Methods From 1989 to 2006, 10 neonates had dual-chamber Epicardial Pacemaker placement for congenital heart block. Mean age and weight were 4.4 ± 5.6 days and 2.8 ± 0.6 kg. Four patients had heterotaxy syndrome and required concomitant cardiac procedures. One patient had fetal hydrops, myocarditis, and cardiomyopathy. Five patients had structurally normal hearts. Sternotomy (2 partial, 8 full) and unipolar leads (2 non–steroid eluting, 18 steroid-eluting) were used in all. Generators were placed in submuscular bilateral rectus sheath pockets. Results Successful atrioventricular synchrony was established in all patients. Mean P-wave sensing was 4.7 ± 2.6 mV and atrial voltage threshold was 0.8 ± 0.3 V. Mean R-wave sensing was 13.0 ± 5.7 mV and ventricular voltage threshold 0.9 ± 0.5 V. There were no wound complications or acute lead failures. Median postoperative stay was 14 days. Three of the 4 patients with heterotaxy died at 3 days, 14 days, and 15 months postoperatively. The patient with cardiomyopathy died suddenly at 6 months of acute myocarditis. No patient with a structurally normal heart died ( P Conclusions Implantation of a dual-chamber Epicardial Pacemaker in neonates with congenital heart block is technically feasible and results in excellent outcomes in patients with structurally normal hearts. System longevity at 6 years is excellent. Patients with congenital heart block and heterotaxy syndrome have a poor prognosis despite dual-chamber pacing.

Carl L Backer - One of the best experts on this subject based on the ideXlab platform.

  • dual chamber Epicardial pacing in neonates with congenital heart block
    The Journal of Thoracic and Cardiovascular Surgery, 2007
    Co-Authors: Angela M Kelle, Carl L Backer, Sabrina Tsao, Robert D Stewart, Wayne H Franklin
    Abstract:

    Objective This review evaluates the outcome of a treatment strategy using dual-chamber Pacemakers for neonates with congenital heart block. Methods From 1989 to 2006, 10 neonates had dual-chamber Epicardial Pacemaker placement for congenital heart block. Mean age and weight were 4.4 ± 5.6 days and 2.8 ± 0.6 kg. Four patients had heterotaxy syndrome and required concomitant cardiac procedures. One patient had fetal hydrops, myocarditis, and cardiomyopathy. Five patients had structurally normal hearts. Sternotomy (2 partial, 8 full) and unipolar leads (2 non–steroid eluting, 18 steroid-eluting) were used in all. Generators were placed in submuscular bilateral rectus sheath pockets. Results Successful atrioventricular synchrony was established in all patients. Mean P-wave sensing was 4.7 ± 2.6 mV and atrial voltage threshold was 0.8 ± 0.3 V. Mean R-wave sensing was 13.0 ± 5.7 mV and ventricular voltage threshold 0.9 ± 0.5 V. There were no wound complications or acute lead failures. Median postoperative stay was 14 days. Three of the 4 patients with heterotaxy died at 3 days, 14 days, and 15 months postoperatively. The patient with cardiomyopathy died suddenly at 6 months of acute myocarditis. No patient with a structurally normal heart died ( P Conclusions Implantation of a dual-chamber Epicardial Pacemaker in neonates with congenital heart block is technically feasible and results in excellent outcomes in patients with structurally normal hearts. System longevity at 6 years is excellent. Patients with congenital heart block and heterotaxy syndrome have a poor prognosis despite dual-chamber pacing.

  • migration and colon perforation of intraperitoneal cardiac Pacemaker systems
    The Annals of Thoracic Surgery, 2007
    Co-Authors: Ali Dodgekhatami, Carl L Backer, Martin Meuli, Rene Pretre, Maren Tomaske, Constantine Mavroudis
    Abstract:

    Epicardial Pacemaker systems include pacing leads and a generator, which exceptionally may have to be implanted in the abdomen. We report three such pediatric cases where severe intraabdominal complications occurred owing to migration and erosion of the generators into visceral organs and urge extreme caution with this technique.

Joshua A Hirsch - One of the best experts on this subject based on the ideXlab platform.

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