DDD pacing mode survival in children with a dual-chamber pacemaker

Background. The persistence of DDD pacing is well documented in adults, how ever, in children survival of the DDD pacing mode is less clear. Methods. We studied the survival of dual-chamber (DDD) pacing in 36 childre n aged 1 week to 16 years who underwent implantation of a dual-chamber paci ng system between January 1986 and October 1998. The children were divided in the following two groups: 26 had epicardial pacing systems and 10 had en docardial pacing systems. Results. During long-term follow-up 11 patients lost the DDD pacing mode. T he DDD pacing survival rate at 3 months and 1, 2, and 5 years was 80%, 77%, 73%, and 69%, respectively. Age, weight, congenital heart disease, and epi cardial pacing leads were not found to be risk factors for loss of DDD paci ng mode. However, P-wave values of less than 2.5 mV at implantation of epic ardial leads were associated with loss of the DDD pacing mode. Conclusions. The majority of children remain in the DDD pacing mode during long-term follow-up. A P-wave value of less than 2.5 mV at implantation of epicardial leads is a risk factor for loss of the DDD pacing mode. (Ann Tho rac Surg 2000;70:1931-4) (C) 2000 by The Society of Thoracic Surgeons.