新生儿永久性心外膜起搏器植入术的长期疗效:印度中心的经验。

IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Annals of Pediatric Cardiology Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI:10.4103/apc.apc_37_24
Deepanjan Bhattacharya, Narayanan Namboodiri, Krishna Kumar Mohanan Nair, Baiju S Dharan, Deepa Sasikumar, Arun Gopalakrishnan, K M Krishnamoorthy, Sabarinath Menon, Sowmya Ramanan, Sudip Dutta Baruah
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引用次数: 0

摘要

简介:新生儿永久起搏器植入术(PPI)在适应症、设备选择、植入技术和长期疗效方面具有挑战性。复杂的解剖结构、高频率的长期起搏需求以及棘手的术后问题是主要问题:方法:我们对我院出生 28 天以下接受 PPI 的 22 名新生儿进行了前瞻性随访:结果:植入时的中位年龄为 2 天(四分位距为 1-9 天),9% 为早产儿。植入前的平均心率为 46.4 ± 7.2 bpm。8名新生儿(36.4%)的母体狼疮抗体呈阳性,11名新生儿(50.0%)伴有先天性心脏病。19名新生儿接受了单腔(VVI)起搏器植入手术,3名新生儿接受了双腔(DDD)起搏器植入手术。中位随访时间为 46 个月(2-123 个月),平均心室起搏率为 87.5 ± 24.9%,起搏阈值稳定。七名患儿在中位年龄 47 个月时因电池耗尽而更换了脉冲发生器。中位年龄为 23.6 个月的五名患儿出现了起搏诱发的心室功能障碍,其中两名患儿接受了心脏再同步化治疗。总死亡率为13.6%,均为植入后组织灌注不足和乳酸酸中毒所致:结论:新生儿 PPI 术后效果良好,导联存活率极高。总死亡率为 13.6%,主要发生在植入后,与心肌功能障碍有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-term outcome of permanent epicardial pacemaker implantation in neonates: Experience from an Indian center.

Introduction: Permanent pacemaker implantation (PPI) in neonates is challenging with respect to indications, device selection, implantation technique, and long-term outcomes. Complex anatomy, the need for long-term pacing with high rates, and a problematic postoperative period are the major problems.

Methods: We prospectively followed up 22 newborns who underwent PPI below 28 days of life at our institute.

Results: The median age at implantation was 2 days (interquartile range 1-9 days), and 9% were born preterm. The average heart rate before implantation was 46.4 ± 7.2 bpm. Maternal lupus antibodies were positive in 8 (36.4%) neonates, whereas 11 (50.0%) had associated congenital heart disease. Nineteen neonates underwent single chamber (VVI) and three underwent dual chamber (DDD) pacemaker implantation. Over a median follow-up of 46 months (range 2-123 months), the average ventricular pacing percentage was 87.5 ± 24.9%, with a stable pacing threshold. Seven children underwent pulse generator replacement due to battery depletion at a median age of 47 months. Pacing-induced ventricular dysfunction was seen in five children at a median age of 23.6 months, and two underwent upgradation to cardiac resynchronization therapy. Overall mortality was 13.6%, all due to tissue hypoperfusion and lactic acidosis in the postimplantation period.

Conclusions: PPI in neonates has a favorable outcome with excellent lead survival. Overall mortality is 13.6%, which is predominantly in the postimplantation period and related to myocardial dysfunction.

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来源期刊
Annals of Pediatric Cardiology
Annals of Pediatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.40
自引率
14.30%
发文量
51
审稿时长
23 weeks
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