Permanent pacemaker implantation after pediatric heart transplantation: Risk factors, indications, and outcomes.
Adolescent
Adult
Arrhythmias, Cardiac
/ mortality
Child
Child, Preschool
Female
Follow-Up Studies
Heart Transplantation
/ mortality
Humans
Infant
Infant, Newborn
Male
Middle Aged
Pacemaker, Artificial
/ statistics & numerical data
Prognosis
Retrospective Studies
Survival Rate
Tissue Donors
/ supply & distribution
Young Adult
heart transplantation
pediatric population
permanent pacemaker implantation
Journal
Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
27
10
2018
revised:
18
01
2019
accepted:
25
01
2019
pubmed:
23
2
2019
medline:
20
6
2020
entrez:
22
2
2019
Statut:
ppublish
Résumé
Permanent pacemaker (PPM) placement in adults following orthotopic heart transplantation (OHT) has been well documented. However, studies concerning the need for PPM implantation in pediatric heart transplant recipients are less common. Institutional transplant and pacing databases as well as patient medical records were reviewed for all pediatric patients undergoing OHT (n = 314; all with bicaval connection) at our institution between January 2000 and March 2018. A total of 16 patients (5.1%) were implanted with a pacemaker after transplantation. Donor age was the only significant risk factor for post-transplant PPM implantation, with a median age of 28.5 years (7.0-49.0) in the pacing group vs 15.5 years (0.4-56.0) in the non-pacing group (P = 0.009). Indication for pacemaker insertion was more often complete heart block (CHB) (12/16, 75%) than sinus node dysfunction (SND) (4/16, 25%). There was no significant difference in mortality between recipients who received a PPM and those who did not (log-rank test; P = 0.345). Increasing donor age is associated with increased PPM placement following pediatric heart transplantation. Interestingly, a high proportion of CHB patients recovered sinus rhythm, and long-term outcomes for paced patients are similar to other heart transplant recipients.
Sections du résumé
BACKGROUND
Permanent pacemaker (PPM) placement in adults following orthotopic heart transplantation (OHT) has been well documented. However, studies concerning the need for PPM implantation in pediatric heart transplant recipients are less common.
METHODS
Institutional transplant and pacing databases as well as patient medical records were reviewed for all pediatric patients undergoing OHT (n = 314; all with bicaval connection) at our institution between January 2000 and March 2018.
RESULTS
A total of 16 patients (5.1%) were implanted with a pacemaker after transplantation. Donor age was the only significant risk factor for post-transplant PPM implantation, with a median age of 28.5 years (7.0-49.0) in the pacing group vs 15.5 years (0.4-56.0) in the non-pacing group (P = 0.009). Indication for pacemaker insertion was more often complete heart block (CHB) (12/16, 75%) than sinus node dysfunction (SND) (4/16, 25%). There was no significant difference in mortality between recipients who received a PPM and those who did not (log-rank test; P = 0.345).
CONCLUSIONS
Increasing donor age is associated with increased PPM placement following pediatric heart transplantation. Interestingly, a high proportion of CHB patients recovered sinus rhythm, and long-term outcomes for paced patients are similar to other heart transplant recipients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13503Informations de copyright
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.