Wireless pacemakers may be safe, effective for children with irregular heart rhythms
Wireless or leadless pacemakers, commonly implanted in adults, may be a safe and effective short-term option for children with slow heartbeats, according to new research published in Circulation: Arrhythmia and Electrophysiology, a peer-reviewed journal of the American Heart Association.
The Pediatric and Congenital Electrophysiology Society (PACES) maintains a registry of pacemaker implantations performed at 15 centers across the U.S., U.K. and Italy. During the study period (2016-2021), cardiac electrophysiologists implanted the leadless device in carefully selected patients who were experiencing a slow heartbeat. Researchers evaluated data in the registry for one brand of leadless pacemakers to analyze how well the leadless pacemaker performed in 63 children, ages 4 to 21 years (average age 15). For 77% of these children, this was their first pacemaker.
The analysis found:
- 62 of the 63 children had the leadless pacemaker successfully implanted, and the heart’s electrical parameters were stable within the first 24 hours.
- During an average follow-up period of about 10 months, the pacemaker was effective in its overall performance, including battery longevity, low pacing threshold (signals if pacemaker is performing well) and ability to detect the heart’s native electrical beats. Pacemaker batteries typically last 5-10 years, depending on how often the device is needed to maintain regular pacing, added Shah.
- Overall, 16% (10) of the children experienced complications after receiving the leadless pacemaker. Most of these were due to minor bleeding, which was treated promptly and easily. There were 3 major complications — one blood clot in the femoral vein of one patient; one cardiac perforation; and one patient had sub optimal pacemaker function requiring removal of the pacemaker after one month.
During the follow-up period after implantation, the leadless pacemakers continued to have stable performance, and there were no reported complications. The researchers have now converted this retrospective study to a prospective study and plan to follow these patients for an additional 5 years.
