Abstract:

Objective To evaluate the treatment method of children with congenital complete atrioventricular block (CCAVB) and atrial septal defect (ASD), and discuss the attention of permanent pacemaker implantation. Methods Based on age and body weight of 3 children with CCAVB and ASD, 1 was implanted with an epicardial pacemaker after repairing ASD by surgical procedure, and 2 were implanted with permanent endocardial pacemakers after interventional procedures for ASD. The model of pacing was VVI for all patients. Results Endocardial pacemaker was attempted to implant in one patient after repairing ASD, while ended up with epicardial pacemaker implantation due to difficulty in lead fastening with small vein. The endocardial pacing was normal during the follow-up. However, the epicardial pacing failed two years after follow up due to lead shifting, and was reset after a new lead installation. No abnormality in cardiac function was found by echocardiography during follow up. Conclusion ASD should first be repaired through interventional or surgical procedures in patients with CCAVB and ASD meeting the indications for permanent pacemaker implantation. Epicardial pacemakers can be implanted in young infants with light weight, and endocardial pacemakers can be implanted in old children after interventional procedures for ASD. There is no significant difference in pacemaker parameters between these two pacing models. More attention should be paid to the lead fastening of epicardial pacing and the room between lead and occluder of endocardial pacing to avoid the lead abrasion.

Key words: congenital complete atrioventricular block, atrial septal defect, permanent pacemaker, children