■SelectSecure无腔3830起搏导线由于其直径较小,通常被认为是儿童经静脉起搏的首选起搏导线,铅强度,和可靠的长期感知和起搏特性。坚固的起搏导线的潜在长期陷阱之一是随着儿童的生长而相对缩回,从而导致晚期导线移位。
■我们在11.8年(案例1)和8.8年(案例2)报告了两例SelectSecure3830晚期导线移位,分别,在初始植入后。病例1在9个月大时被诊断为先天性完全性心脏传导阻滞(CHB),当时他患有未经证实的白喉感染。病例2在14周龄时诊断为CHB,母体抗Ro抗体阳性。由于有症状的心动过缓,两名患者均接受了MedtronicSelectSecure3830导线的经静脉永久性起搏器植入术。除了8.5年(案例1)和7年(案例2)的脉冲发生器变化外,分别,植入后由于正常的电池耗尽,两名患者在过渡期间都很好。
■作为快速成长儿童起搏器随访的一部分,我们建议通过胸部X线照相术更频繁地监测铅\'紧绷\',特别是在没有潜在心律的CHB儿童中。
UNASSIGNED: The SelectSecure lumenless 3830 pacing lead is often considered to be the pacing lead of choice for transvenous pacing in children because of its small diameter, lead strength, and reliable long-term sensing and pacing characteristics. One of the potential long-term pitfalls of a sturdy pacing lead is relative retraction with growth in children resulting in late lead dislodgement.
UNASSIGNED: We report two cases of late SelectSecure 3830 lead dislodgement at 11.8 years (
Case 1) and 8.8 years (
Case 2), respectively, post the initial implantation.
Case 1 was diagnosed with congenital complete heart block (CHB) at 9 months old when he presented with unconfirmed diphtheria infection.
Case 2 was diagnosed with CHB at 14 weeks of age with positive maternal anti-Ro antibodies. Both patients underwent implantation of a transvenous permanent pacemaker implantation with Medtronic SelectSecure 3830 lead due to symptomatic bradycardia. Apart from a pulse generator change at 8.5 years (
Case 1) and 7 years (
Case 2), respectively, post-implant due to normal battery depletion, both patients are well in the interim.
UNASSIGNED: As part of the pacemaker follow-up for rapidly growing children, we recommend more frequent surveillance of lead \'tautness\' by chest radiography especially in children with CHB with no underlying heart rhythm.