The efficacy of ventricular pacing with device automaticity in paediatric patients

• Published in: Europace (London, England) England), 2008-07, Vol.10 (7), p.838-843
• Main Authors: Tomaske, Maren, Harpes, Paul, Woy, Natascha, Bauersfeld, Urs
• Format: Article
• Language: English
• Subjects: Adolescent; Cardiac Pacing, Artificial - methods; Child; Child, Preschool; Electrocardiography, Ambulatory; Equipment Safety; Female; Heart Diseases - physiopathology; Heart Diseases - therapy; Humans; Infant; Infant, Newborn; Male; Monitoring, Ambulatory - methods; Pacemaker, Artificial; Retrospective Studies; Software; Treatment Outcome; Ventricular Function - physiology
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/eun038

Aims To compare pacemaker reprogramming and re-intervention rates in children with AutoCapture® (AC) and conventionally (Conv) programmed devices, and to assess reliability of device automaticity. Methods and results Data of children with AC (group AC, n = 49) and conventionally programmed devices (group Conv, n = 41) were analysed. A total of 1106 outpatient visits and 147 Holter recordings were screened for device reprogramming and invasive re-intervention. At 2 and 5 years, freedom from reprogramming differed significantly between groups (AC: 63/35% vs. Conv: 13/4%; P < 0.0001), whereas freedom from re-intervention was not different (AC: 95/90% vs. Conv: 95/85%; P = 0.26). Mean yearly rate of reprogramming was lower in group AC (AC: 0.67 ± 0.55 vs. Conv: 1.13 ± 0.82; P = 0.005). Follow-up duration correlated with a decreasing number of reprogramming per year in group Conv (ρ = −0.73, P < 0.001). No ventricular output reprogramming was required in group AC. Holter recordings required 0.07 ± 0.13 reprogramming per year in group Conv, none in group AC (P < 0.001). Holter-detected lead dysfunction prompted re-intervention in one patient of each group. Conclusion Estimated freedom from as well as total yearly rate of device reprogramming was favourable for AC-programmed devices. No difference was seen for the incidence of invasive re-interventions. AC ventricular output control was effective. Structured device follow-up and Holter recordings in specific patient groups remain mandatory for all devices in paediatric patients.