Staged pacing therapy for congenital complete heart block in premature infants.
Staged pacing therapy for congenital complete heart block in premature infants.
复制标题
早产儿先天性完全性心脏传导阻滞的分阶段起搏治疗。
DOI：
10.1016/0002-9149(94)90419-7
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Walsh,EP
中科院分区：
文献类型：
--
作者：
Weindling,SN;Saul,JP;Triedman,JK;Burke,RP;Jonas,RA;Gamble,WJ;Walsh,EP
Although congenital complete heart block (CHB) is usually well tolerated by the developing fetus, it may occasionally result in hydrops fetalis1,2with a significant risk of fetal or neonatal death.3The treatment of the fetus with CHB and hydrops remains a difficult problem. Attempted pharmacologic therapies have included β-adrenergic agonists,3corticosteroids,4and intravenous immunoglobulins,5none of which have been widely effective. One report of transuterine transthoracic fetal ventricular pacing was not successful in bringing the fetus to term.6Although animal studies of fetal permanent pacemaker systems implantation are under way,7this approach has not been used in humans. Because currently available in utero therapy is unable to halt the progression of fetal hydrops, one must usually resort to early delivery and extrauterine pacing of a compromised (and often premature) neonate. On occasion, these infants are too small to accept immediate implantation of a permanent pacing system, and use of temporary transvenous pacing wires carries the risk of cardiac perforation and venous thrombosis in the very small child. This report describes an alternate pacing strategy in 2 premature infants with CHB, involving the use of temporary epicardial pacing wires to bridge the interval until the permanent pacemaker can be implanted.
