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The long term prognosis of pacemaker implantation among children

, : The long term prognosis of pacemaker implantation among children. Sapporo Medical Journal 54(2): 139-146

For the past 13 yr, pacemaker implantation was performed in 21 patients in the clinic. The patients (7 females and 14 males) were under 15 yr of age. The mean age at the time of operation was 7 yr. Thirty nine pulse generations in total were implanted. Seventeen case (81%) used a myocardial lead. An endocardial lead was used in 4 cases over 13 yr of age. The indications for pacemaker implantation were 4 cases of congenital heart block, 2 cases of sick sinus syndrome, 1 case of paroxysmal atrial tachycardia and 14 case of postoperative complete heart block. Because battery exhaustion was noted in 18 cells, new pacemakers were implanted. Complications included 5 cases of threshold elevation, 3 cases of lead fracture, 1 case of twiddler's syndrome and 1 case of left ventricular rupture by a screw type led et al. They were named properly. To prevent the thresholds elevation, it is important to measure the threshold of a pacemaker lead at the time of primary implantation as well as at the time of generator change. Seen cases died after pacemaker implantation. A pacemaker related death was in 1 case where the patient died from pacemaker battery failure. Fourteen patients are presently alive (67%). All cases, including 8 surgical heart blocks, are doing well, enjoying an active life. The rate of complication decreased with growth.

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