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. 2013 Jan;6(1):46-51.
doi: 10.4103/0974-2069.107234.

Pacing in children

Harinder R Singh  1 , Anjan S Batra, Seshadri Balaji
Affiliations

Pacing in children

Harinder R Singh et al. Ann Pediatr Cardiol. 2013 Jan.

Abstract

The implantation of cardiac pacing devices in children and young adults can be challenging and different from the adult population due to their smaller size, their longer life expectancy, and anatomical variations associated with congenital heart defects. A knowledge of indications, pacing leads and devices, anatomical variations, and the technical skills are important for those who implant and care for children with pacemakers. In this review we attempt to discuss these specific points of cardiac pacing in children and young adults.

Keywords: Congenital heart defects; heart block; pacemakers; pacing.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Dual chamber pacemaker showing implantation of the atrial lead in the high right atrium and septal implantation of the ventricular lead, with extra slack in the atrial and ventricular leads
Figure 2
Figure 2
The axillary venogram shows the course of the vein as it courses the junction of the outer border of the first rib with the inferior margin of the clavicle
Figure 3
Figure 3
Venograms showing complete occlusion of the left subclavian (a) and proximal right subclavian (b) vein in a patient with an existing ICD lead that was fractured. (c) A guide wire (platinum plus 018, Boston scientific) was threaded from the right subclavian vein into the IVC through the stenotic site. (d) A dilator and sheath were then cannulated over the guide wire and used to pass two additional leads across this stenotic site
Figure 4
Figure 4
The RV lead is placed via a transhepatic approach in a 12-year-old girl for symptomatic recurrent asystolic pauses following a motor vehicular accident. She had multiple fractures of her vertebral column requiring placement of a cranial halo with traction. The access to the usual veins was limited, and therefore the lead was placed via transhepatic approach
Figure 5
Figure 5
An AP and lateral view of a CXR showing a dual chamber pacemaker in a patient with Mustard procedure for D-TGA. Notice the placement of the atrial lead in the superior aspect of the left atrium and the ventricular lead in the posterior left ventricle
See this image and copyright information in PMC

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