Abstract
We evaluated our recent experience with pacemaker (PM) treatment of sick sinus syndrome (SSS) in pediatric patients (pts). In the past 5 years, 21 pts underwent implantation of permanent PM for SSS: 12 had had prior surgery for associated structural heart disease (SHD), 5 had no SHD; 2 had drug-induced SSS, 1 had unoperated SHD, 1 had cardiomyopathy. The median age was 8 yrs (range 2-21 yrs). Twenty pts had syncope or marked exercise intolerance. Each pt had an intracardiac electrophysiologic study and each had an abnormal corrected sinus node recovery time (mean 687 ± 53msec SEM). Supraventricular tachycardia (SVT) was documented in 15 pts: 7 atrial muscle reentry, 4 sinus node reentry, 2 Kent bundle reentry, 1 AV node reentry, 1 atrial ectopic focus. Ten pts had normal AV conduction and received an epicardial atrial PM. Eleven pts had abnormal AV conduction and received an epicardial ventricular PM. No pt has died during mean followup of 31 mos (range 6-63 mos). Symptoms due to bradycardia were relieved in each pt. SVT has become easier to control in 11/15 pts; SVT worsened in both pts with Kent bundles. One atrial PM and 2 ventricular PMs failed to sense, requiring revision. No PM has failed to capture and no battery has yet depleted. We conclude: pacing for SSS in pediatric pts reliably relieves symptoms of bradycardia, facilitates treatment of SVT and may prevent sudden death.
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Hesslein, P., Gillette, P., Garson, A. et al. 151 PACEMAKER THERAPY FOR SICK SINUS SYNDROME IN CHILDREN. Pediatr Res 15 (Suppl 4), 465 (1981). https://doi.org/10.1203/00006450-198104001-00160
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DOI: https://doi.org/10.1203/00006450-198104001-00160