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Endocardial and epicardial steroid lead pacing in the neonatal and paediatric age group
  1. F Udink Ten Cate1,
  2. J Breur1,
  3. N Boramanand2,
  4. J Crosson3,
  5. A Friedman2,
  6. J Brenner3,
  7. E Meijboom1,
  8. N Sreeram1
  1. 1Wilhelmina Children's Hospital, Utrecht, Netherlands.
  2. 2Yale New Haven Hospital, New Haven, Connecticut, USA
  3. 3The Johns Hopkins Hospital, Baltimore, Maryland, USA
  1. Correspondence to:
    Dr N Sreeram, Wilhelmina Children's Hospital, PO Box 85090, 3508 AB Utrecht, Netherlands;


Aim: To compare the performance of steroid eluting epicardial and endocardial leads in infants and children requiring permanent pacing.

Methods: Evaluation of pacing and sensing characteristics, impedances, and longevity of 159 steroid eluting leads implanted in 95 children. Group A consisted of 24 children weighing less than 15 kg with 15 endocardial leads (five atrial, 10 ventricular) and 19 epicardial leads (five atrial, 14 ventricular). Group B consisted of 71 children weighing more than 15 kg with 106 endocardial leads (56 atrial, 58 ventricular) and 19 epicardial leads (nine atrial, 10 ventricular).

Results: Group A: Stimulation thresholds were lower for ventricular endocardial leads at implant (mean (SD) 0.84 (0.54) v 1.59 (0.64) V, p < 0.014) and at two year follow up (ventricular 0.64 (0.24) v 1.65 (0.69) V, p < 0.003). Impedance and sensing thresholds did not differ significantly at implant and follow up. Group B: Stimulation thresholds were lower for ventricular endocardial leads at implant (0.72 (0.48) v 1.48 (0.58) V, p < 0.001) and at follow up (0.88 (0.46) v 1.55 (0.96) V, p < 0.009). Impedance did not differ. Sensing thresholds were also better for ventricular endocardial leads at follow up (9.1 (5.2) v 14.2 (6.4) mV, p < 0.02). Complications requiring intervention occurred in both groups (n = 7 for endocardial v n = 18 for epicardial leads).

Conclusions: Endocardial and epicardial steroid eluting leads have comparable performance in the paediatric population.

  • steroid eluting pacing lead
  • pacemaker
  • neonatal
  • paediatric

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