Pacemaker therapy in isolated congenital complete atrioventricular block

被引:45
作者
Breur, JMPJ
Ten Cate, FEAU
Kapusta, L
Cohen, MI
Crosson, JE
Boramanand, N
Lubbers, LJ
Friedman, AH
Brenner, JI
Vetter, VL
Sreeram, N
Meijboom, EJ
机构
[1] Wilhelmina Childrens Hosp, UMC, Dept Pediat Cardiol, Utrecht, Netherlands
[2] Univ Nijmegen, Med Ctr, Childrens Heart Ctr, Dept Pediat Cardiol, Nijmegen, Netherlands
[3] Childrens Hosp Philadelphia, Dept Pediat Cardiol, Philadelphia, PA 19104 USA
[4] Johns Hopkins Univ Hosp, Dept Pediat Cardiol, Baltimore, MD 21287 USA
[5] Yale New Haven Med Ctr, Dept Pediat Cardiol, New Haven, CT 06504 USA
[6] Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2002年 / 25卷 / 12期
关键词
complete heart block; congenital; pediatrics; pacing;
D O I
10.1046/j.1460-9592.2002.01685.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to evaluate the effect of pacemaker (PM) therapy in patients with isolated congenital complete atrioventricular block (CCAVB). Patients with CCAVB eventually qualify for PM implantation, however, timing remains controversial. Retrospective evaluation of left ventricular end-diastolic diameter (LVEDD), shortening fraction (SF), and cardiothoracic ratio (CTR) in 149 CCAVB patients, before, at, and after PM implantation was carried out. LVEDD shows an average increase of 0.48%/month in non-PM patients, and an average decrease of 0.88%/month in PM patients. SF shows an average increase of 0.10%/month in non-PM, and an average decrease of 0.32%/month in PM patients. CTR shows an average increase of 0.02%/month in non-PM, and an average decrease of 0.19%/month in PM patients. The difference between the non-PM and PM groups is significant (P = 0.05) for all variables. Symptomatic patients show no significant change in LVEDD after PM therapy (from 66.5% before to 68.5% after PM therapy). Asymptomatic patients do show a significant (P < 0.001) decrease in LVEDD after PM therapy (from 78.4% before to 73.3% after PM therapy). CTR does not differ significantly between Symptomatic and asymptomatic patients before PM therapy (58% and 57%, respectively). CTR does differ significantly (P < 0.001) between symptomatic and asymptomatic patients after PM therapy (52% and 48%, respectively). Heart size and SF are increased in most patients with isolated CCAVB. PM implantation is associated with a decrease in heart size and normalization of SF in most patients. Indications for PM therapy in children may require reevaluation in asymptomatic patients with increased cardiac size and decreased cardiac function.
引用
收藏
页码:1685 / 1691
页数:7
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