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Europace 2005 7(3):291; doi:10.1016/j.eupc.2005.02.017
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

CP19: RIGHT VENTRICLE PACING SITE SELECTION IN CHILDREN

Vjacheslav A. Bazaev and Olga L. Bockeria

Bakoulev Scientific Center for cardio-vascular surgery Moscow, Russia

Purpose of study to evaluate the advantage of the interventricular right ventricle (RV) pacing on the RV apex pacing in children with permanent pacemakers.

METHODS USED: 112 children (59 males (52.6%)) at the age of 15 to 192 month (mean age 99.6 ± 68.6 month) underwent the pacemaker implantation from 2001 to 2004. 58 children (51.8%) have a postoperative atrio-ventricular block, 54 children (48.2%) have a congenital atrio-ventricular block. 48 patients (42.8%) were paced in VVI mode. 23 patients (20.5%) were paced in VVIR mode. 41 (36.6%) were paced in dual–chamber rate-responsive pacing mode. In 42 patients (37.5%) the ventricle lead was posizioned in right ventricle and screwed in the upper or middle part of the interventricular septum. In the rest of patients (70(62.5%)) ventricular lead was implanted in the RV apex.

RESULTS: QRS duration was significantly shorter (p>0.05) in patient with interventricular septum pacing system (0.89+0.03 mc) vs. RV apex pacing system (0.14+0.04 mc). There was no paradoxal motion of the interventricular septum. Futhermore in these patients was no signs of the congestive heart failure in long follow-up period. The engection fraction was significantly high (55,8 +10,8 % vs. 34,17+5,3 %) in this group of patients.

CONCLUSION: The upper part of the interventricular septum is apreferable site for the permanent right ventricular pacing in children.


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