Journal of Clinical Pediatrics ›› 2019, Vol. 37 ›› Issue (7): 489-.doi: 10.3969/j.issn.1000-3606.2019.07.003

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Long-term effects of high lateral posterior wall epicardial pacing on cardiac function in children

ZENG Ziliang, ZENG Shaoying, XU Gang, et al   

  1. 1.Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; 2.Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, Guangdong, China
  • Published:2019-07-18

Abstract: Objective To observe and analyze the changes of left ventricular function after long-term left ventricular high lateral posterior wall epicardial pacing, and to explore the optimal location of epicardial electrode implantation. Methods Clinical and echocardiography data before operation and at last follow-up in 56 children implanted left ventricular high lateral wall epicardial pacing electrode from November 2008 to August 2016 were retrospectively analyzed. The results of two ultrasound examinations were analyzed. Results Among the 56 cases, 31 had postoperative bradyarrhymia, and 25 had congenital or myocarditis bradyarrhymia. The median age at the implantation was 3.25 years, and the median follow-up period was 1.63 years. Ultrasound examination showed that preoperative left ventricular ejection fraction (LVEF) and left atrial (LA) diameter were (66.39±9.96) % and (25.48±7.22) mm respectively, and LVEF and LA diameter at the last follow-up were (69.32±7.13) % and (23.44±6.29) mm respectively, and the differences were statistically significant (P<0.05). The left ventricular end diastolic diameter (LVDd) and left ventricular end systolic diameter (LVDs) Z scores were ?1.42 (?4.67~0.89) and 0.06 (?2.39~2.72) at last follow-up, which were significantly reduced compared with 0.16 (?1.31~2.83) and ?1.88 (-4.48~0.10) at preoperation, and differences were statistically significant (P<0.05). Conclusion High lateral posterior wall pacing of left ventricle can effectively protect and improve left ventricular function. It is an ideal location for epicardial implantation of pacing electrode in pediatric treatment of bradyarrhythmia.

Key words: left ventricular function; epicardium; pacing therapy; Z score