Transmural atrial pacing in patients with postoperative congenital heart disease

Christopher L. Johnsrude, Carl L. Backer, Barbara J. Deal, Janette F. Strasburger, Constantine Mavroudis

Research output: Contribution to journalArticle

Abstract

Transmural Pacing in Congenital Heart Disease. Introduction: Some patients with postoperative congenital heart disease require permanent cardiac pacing, but the use of transvenous or epicardial pacing leads may be limited by type of cardiac malformation, venous connections, body size, or fibrosis. Transmural atrial pacing may provide an alternative in difficult patients, but to date has been described in only a few articles with small patient numbers, and data from lead performance are lacking. Methods and Results: Records were reviewed in 18 consecutive patients (4 months to 21 years old) with postoperative congenital heart disease receiving transmural atrial pacing leads from July 1994 to December 1996. Implantation materials and techniques were described. Lead sensing and capture thresholds obtained acutely and during short-term follow-up (mean: 11.0 months) were evaluated, and comparisons were made between patients with postoperative Fontan anatomy and non-Fontan patients, and between patients receiving steroid-eluting and nonsteroid leads. Overall, the median acute sensing and capture thresholds of transmural leads were 4.1 mV and 0.7 V at 0.5 msec, respectively. Median follow-up thresholds were 2.8 mV and 0.8 V, respectively. Performance of leads in Fontan patients was similar to those in non-Fontan patients. Steroid-eluting leads had a chronic capture threshold of 0.6 V versus 0.9 V for nonsteroid leads (P = 0.038). Conclusion: Transmural atrial pacing leads were successfully implanted in patients with diverse ages and types of postoperative congenital heart disease. Lead performance was acceptable both acutely and during the first year of follow-up.

Original languageEnglish (US)
Pages (from-to)351-357
Number of pages7
JournalJournal of cardiovascular electrophysiology
Volume10
Issue number3
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

Keywords

  • Congenital heart disease
  • Fontan operation
  • Pediatric pacemaker
  • Steroid elution
  • Transmural pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Transmural atrial pacing in patients with postoperative congenital heart disease'. Together they form a unique fingerprint.

  • Cite this