Abstract
We have reviewed our recent experience with 10 young patients requiring chronic cardiac pacing. Details of the performance of the most recent two generators are summarized. Six patients required pacing for symptomatic congenital complete heart block, two for postoperative complete heart block, one for heart block associated with idlopathic myocardiopathy and one for the sick sinus syndrome. Pacemaker generators were implanted beneath the pectoral muscle to elminate cutaneous erosion in small or slender patients. Seven patients underwent transvenous pacemaker electrode implantation into the right ventricle. Although our patients have had a variety of generators, we currently use the Brownlee-Tyers, rechargeable silver modified mercury-zinc generator, with a proven life span of 6 years and an anticipated life span of 20 years. All patients have been monitored transtelephonically. In those requiring change, all on an elective basis, the average conventional generator life span has been 27 months (range 20-44 months). None of the Brownlee-Tyers generator units have required replacement. No wire fractures have occurred, though one transvenous electrode required repositioning 1 month following insertion. No long term electrode complications have occurred in children with transvenous placement including one patient in whom the electrode was placed at 7 years of age and followed for 9 years. The improved prognosis detailed in this report is the result of improved generator and electrode construction, surgical technique and monitoring methods.
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Whitman, V., Berman, W., Frank, G. et al. PACEMAKERS IN YOUNG PATIENTS: 1976. Pediatr Res 11, 402 (1977). https://doi.org/10.1203/00006450-197704000-00198
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DOI: https://doi.org/10.1203/00006450-197704000-00198