Journal Article

Selective-site pacing in paediatric patients: use of the SelectSecure System and risk of vein occlusion

Fulvio Gabbarini and Gabriella Agnoletti

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 12, issue 9, pages 1286-1289
Published in print September 2010 | ISSN: 1099-5129
Published online July 2010 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/euq268
Selective-site pacing in paediatric patients: use of the SelectSecure System and risk of vein occlusion

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Aims

Few data are available about selective-site pacing in children. A 4.1 Fr lead is now available: it has to be introduced through an 8.4 Fr steerable catheter, and it raises concerns as to the long-term patency of the subclavian vein. The aim of this study was to systematically evaluate the patency of the subclavian vein in children who had selective-site pacing by the SelectSecure Lead System (SSLS) for atrioventricular block and look for possible local early and late complications.

Methods and results

From June 2006 to January 2010, we implanted 20 patients. Mean age at implantation was 9 years (range 3–16), mean weight 31 kg (range 13–57). All patients received a dual-chamber pacemaker (PM). The patency of the subclavian vein was evaluated by ultrasound 1, 3, and every 6 months after the PM implantation. We also looked for oedema, swelling, changes in temperature or colour of the skin, and visible superficial circulation. Forty leads were implanted in 20 patients. After a median follow-up of 19 months (range 6–44), no clinical signs or symptoms of vein occlusion were detected in the whole population. None of the patients had an alteration of blood flow at Doppler examination.

Conclusion

The SSLS is a promising and safe system for permanent intracardiac pacing in paediatric patients. We show that it does not increase the risk of venous thrombosis. Until a venography study with a larger population and longer follow-up regarding venous patency and overall complications using SSLS will be performed, our results although promising have to be considered preliminary data.

Keywords: Selective; Pacing; Paediatric; Leads

Journal Article.  1703 words.  Illustrated.

Subjects: Cardiovascular Medicine

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