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Europace Advance Access published online on March 3, 2008
Europace, doi:10.1093/europace/eun038
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

The efficacy of ventricular pacing with device automaticity in paediatric patients

Maren Tomaske1,*, Paul Harpes2, Natascha Woy1 and Urs Bauersfeld1

1 Division of Paediatric Cardiology, University Children’s Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland; 2 Biostatistic Unit, University Zurich, Zurich, Switzerland

Aims: To compare pacemaker reprogramming and re-intervention rates in children with AutoCapture® (AC) and conventionally (Conv) programmed devices, and to assess reliability of device automaticity.

Methods and results: Data of children with AC (group AC, n = 49) and conventionally programmed devices (group Conv, n = 41) were analysed. A total of 1106 outpatient visits and 147 Holter recordings were screened for device reprogramming and invasive re-intervention. At 2 and 5 years, freedom from reprogramming differed significantly between groups (AC: 63/35% vs. Conv: 13/4%; P < 0.0001), whereas freedom from re-intervention was not different (AC: 95/90% vs. Conv: 95/85%; P = 0.26). Mean yearly rate of reprogramming was lower in group AC (AC: 0.67 ± 0.55 vs. Conv: 1.13 ± 0.82; P = 0.005). Follow-up duration correlated with a decreasing number of reprogramming per year in group Conv ({rho} = –0.73, P < 0.001). No ventricular output reprogramming was required in group AC. Holter recordings required 0.07 ± 0.13 reprogramming per year in group Conv, none in group AC (P < 0.001). Holter-detected lead dysfunction prompted re-intervention in one patient of each group.

Conclusion: Estimated freedom from as well as total yearly rate of device reprogramming was favourable for AC-programmed devices. No difference was seen for the incidence of invasive re-interventions. AC ventricular output control was effective. Structured device follow-up and Holter recordings in specific patient groups remain mandatory for all devices in paediatric patients.

Key Words: Pacing system, Device automaticity, Paediatric patients, Follow-up, Holter recordings

* Corresponding author. Tel: +41 44 2667519; fax: +41 44 2667981. E-mail address: maren.tomaske{at}kispi.uzh.ch

Manuscript submitted 12 October 2007. Accepted after revision 3 February 2008.


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