Cardiac pacing and defibrillation in children and young adults

Abstract

The population of children and young adults requiring a cardiac pacing device has been consistently increasing. The current generation of devices are small with a longer battery life, programming capabilities that can cater to the demands of the young patients and ability to treat brady and tachyarrhythmias as well as heart failure. This has increased the scope and clinical indications of using these devices. As patients with congenital heart disease (CHD) comprise majority of these patients requiring devices, the knowledge of indications, pacing leads and devices, anatomical variations and the technical skills required are different than that required in the adult population. In this review we attempt to discuss these specific points in detail to improve the understanding of cardiac pacing in children and young adults.

Keywords: ICDs; Pacemakers; congenital heart defects; pacing; pediatrics.

Figure 1

Dual chamber pacemaker lead implantation in a patient with left SVC without a bridging vein.

Figure 2

Use of an ICD coil in the left axillary vein in a patient with right sided generator implant to lower the DFTs. The atrial lead is in the posterior high right atrial septum near the Bachmann's bundle.