Therapeutic Research

Abstract

Background：In transvenous cardiovascular implantable electronic device（CIED）implantations for children, we have to consider their growth and the rest of their life. This paper will outline a patient that we treated at our institute. Case： The patient was a 13–year –old girl who underwent ventricular septal defect closure at 4 months old. At that time, she suffered complete atrioventricular block induced by the surgical procedure. So she underwent an epicardial pacemaker implantation at 5 months old and had received VVIR pacing since then. After that, she was diagnosed with left ventricular noncompaction and began taking medicine. She was admitted to our institute following syncope due to pacing failure that was caused by incomplete lead fracture. After due consideration of her physique and growth, we performed a transvenous pacemaker implantation on her. We chose a generator that had a rate response function controlled by a blended sensor, because her heart responses controlled by an accelerometer had not been satisfactory despite her low left ventricular ejection fraction. The blended sensor dramatically improved her heart rate responses. In addition to this, we considered remote monitoring system, lead management and the longevity of a generator. Conclusion：In transvenous CIED implantations for children, the selection of generators or leads is often limited due to their small bodies and growth. However, transvenous CIED implantations for children can be more satisfactory if we devise a method or way of implantation based on each patient’s situation.