Research Article
Volume 11 Issue 4 - 2022
Study of Postoperative Pacing in Children and Risk Factors for Permanent Pacemaker Implantation. Α Single Center Experience

yriakoulis Konstantinos1*, Giannopoulos Nikolaos2, Drakopoulou Maria4, Tsoutsinos Alexander3, Kakava Felicia1, Kourelis Georgios1, Bobos Dimitrios2, Kanakis Meletios2, Rammos Spyridon3 and Papagiannis John3

1Pediatric Cardiac Intensive Care Unit, Onassis Cardiac Surgery Center, Kallithea, Athens, Greece

2Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Kallithea, Athens, Greece

3Department of Pediatric Cardiology and Adult Congenital Heart Disease, Onassis Cardiac Surgery Center, Kallithea, Athens, Greece

4First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece

*Corresponding Author: Kyriakoulis Konstantinos, Consultant Pediatric Intensivist, Pediatric Cardiac Intensive Care Unit, Onassis Cardiac Surgery Center, Kallithea, Athens, Greece.
Received: February 24, 2022; Published: March 30, 2022




Abstract

Aim: Our aim was to identify predictors for Permanent Pacemaker (PPM) implantation.

Methods: We performed a retrospective analysis of patients under 18 years of age who received postoperative pacing through a temporary external pacemaker, between 2002 and 2020. Patients were divided in two groups: 1) permanent, when a PPM was implanted before discharge or 2) temporary if PPM was not implanted. Demographic characteristics, anatomic diagnosis and perioperative variables of the two groups were compared.

Results: Overall, 2.985 patients were operated and 286 (9.6%) received postoperative pacing. Temporary pacing was performed in 245 (8.2%) patients and 41 (1.4%) patients received a PPM. Independence from the temporary external pacemaker was achieved in 91% of patients of the temporary group on day 10. Patients in the permanent group needed pacing from the first hour of admission to PICU much more often than patients in the temporary group (92.7% vs 60.4%, p < 0.001). On univariable analysis, increased age (p = 0.02) and number of previous surgeries (p = 0.02) and segmental anatomy {S,L,L} (p = 0.04) were significantly higher in the permanent group. Multivariable logistic regression analysis identified that increased number of previous cardiac surgeries (OR = 1.99, 95% CI = 1. 1.21 - 3.29, p = 0.007) was an independent risk factor for PPM implantation.

Conclusion: Patients with need for pacing from the first hour of admission to PICU, persistent need beyond the 10th postoperative day, atrioventricular discordance and especially those who had multiple previous surgeries are more likely to require permanent pacing.

 

Keywords: Postoperative Pacing; Permanent Pacemaker Implantation; Children; Heart Surgery; Congenital Heart Disease

References

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Citation: Kyriakoulis Konstantinos., et al. “Study of Postoperative Pacing in Children and Risk Factors for Permanent Pacemaker Implantation. Α Single Center Experience”. EC Paediatrics 11.4 (2022): 64-73.

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