The following is a summary of “Experience of treating congenital complete atrioventricular block with epicardial pacemaker in infants and young children: a retrospective study,” published in the November 2023 issue of Cardiology by Song et al.

Researchers conducted a retrospective study to review treatment strategies for congenital complete atrioventricular block (CCAVB) in newborns and infants, exploring the need for and feasibility of permanent pacemaker implantation in this patient population.

They analyzed clinical data and follow-up results for nine children admitted to their center with CCAVB (January 2005 to March 2023). Among them, 2 children underwent early permanent pacemaker implantation (within 1 year of age), 2 underwent non-early implantation (1 year or older), and the remaining 5 received no pacemaker implantation. CCAVB diagnosis was confirmed through clinical symptoms and examinations, including electrocardiography and echocardiography before surgery. Post-surgery, the pacemaker’s functions were monitored using electrocardiography, echocardiography, and pacing threshold monitoring. A comprehensive evaluation of treatment efficacy encompassed improvements in clinical symptoms, growth, development, and absence of complications, and non-pacemaker patients underwent subsequent follow-up.

The results showed that among the successfully implanted pacemakers in four children, one child who received non-early implantation experienced mortality. For the remaining three children, the pacemaker exhibited good threshold level, amplitude, impedance, and minute ventilation sensor function during the follow-up period, maintaining a heart rate at the pacing rate. The growth and development of these patients adhered to the percentile curve, with unaffected motor and cognitive development. However, two children without pacemaker implantation died, and three were lost to follow-up, limiting the assessment of their long-term outcomes.

They concluded that early epicardial pacemaker implantation benefits newborns and infants with CCAVB, improving symptoms without compromising growth and development.

Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-023-03620-1