{"id":3629,"date":"2010-01-09T15:27:01","date_gmt":"2010-01-09T15:27:01","guid":{"rendered":"http:\/\/cardiophile.org\/?p=3629"},"modified":"2023-11-18T16:50:06","modified_gmt":"2023-11-18T11:20:06","slug":"pacing-in-small-infants","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/","title":{"rendered":"Pacing in small infants"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/J_1htYnURIc?si=0kdcF2jNuOdzjIDq\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Pacing in small infants<\/span><\/h2>\n<p><strong>Issues on transvenous pacing in small infants<\/strong><\/p>\n<p>Important concerns in transvenous pacing pacing in small infants are venous thrombosis due to the small veins and growth issues producing lead stretch, redundancy and displacement when an extra loop is kept, and infections. Paradoxical embolism is possibility in those with right to left shunts. Endocardial leads are better avoided in such situations. Ultrasound follow up is obtained at least once in two years to check for venous thrombosis. A venographic study showed 25% incidence of venous obstruction of which 13% was complete and 12% partial.<\/p>\n<p><strong>Limitations of epicardial approach for pacing in small infants<\/strong><\/p>\n<p>Higher failure rates, unipolar leads, poor battery life due to high chronic thresholds or low impedance. Lead survival is lesser for epicardial approach. Bipolar leads have lesser energy drainage.<\/p>\n<p><strong>Factors in favour of epicardial pacing in small children<\/strong><\/p>\n<p>Epicardial pacing can be done through a mini lateral thoracotomy. Left ventricular apical pacing is thought to be better than right ventricular apical pacing in terms of left ventricular ejection fraction. The need for lead extraction is delayed in epicardial pacing. Button leads are better than screw in leads for epicardial pacing. Steroid eluting button leads have good performance. Smaller children can go for epicardial pacing and later on when revision is required, for transvenous pacing.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Pacing in small infants: limitations of transvenous pacing and epicardial pacing and some advantages of epicardial approach are discussed.<\/p>\n","protected":false},"author":1,"featured_media":37206,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6],"tags":[576,577,1384,3498,3714],"class_list":["post-3629","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","tag-button-leads","tag-button-leads-for-epicardial-pacing","tag-epicardial-pacing","tag-screw-in-leads","tag-steroid-eluting-leads"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pacing in small infants - pros and cons of epicardial and transvenous<\/title>\n<meta name=\"description\" content=\"Pacing in small infants: limitations of transvenous pacing and epicardial pacing and some advantages of epicardial approach are discussed.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pacing in small infants - pros and cons of epicardial and transvenous\" \/>\n<meta property=\"og:description\" content=\"Pacing in small infants: limitations of transvenous pacing and epicardial pacing and some advantages of epicardial approach are discussed.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2010-01-09T15:27:01+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-11-18T11:20:06+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Pacing in small infants\",\"datePublished\":\"2010-01-09T15:27:01+00:00\",\"dateModified\":\"2023-11-18T11:20:06+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/\"},\"wordCount\":221,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"button leads\",\"button leads for epicardial pacing\",\"epicardial pacing\",\"screw in leads\",\"steroid eluting leads\"],\"articleSection\":[\"ECG \\\/ Electrophysiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/\",\"name\":\"Pacing in small infants - pros and cons of epicardial and transvenous\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2010-01-09T15:27:01+00:00\",\"dateModified\":\"2023-11-18T11:20:06+00:00\",\"description\":\"Pacing in small infants: limitations of transvenous pacing and epicardial pacing and some advantages of epicardial approach are discussed.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/pacing-in-small-infants\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Pacing in small infants\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\",\"name\":\"All About Cardiovascular System and Disorders\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\",\"name\":\"Johnson Francis\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"caption\":\"Johnson Francis\"},\"logo\":{\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\"},\"description\":\"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/author\\\/jf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Pacing in small infants - pros and cons of epicardial and transvenous","description":"Pacing in small infants: limitations of transvenous pacing and epicardial pacing and some advantages of epicardial approach are discussed.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/","og_locale":"en_US","og_type":"article","og_title":"Pacing in small infants - pros and cons of epicardial and transvenous","og_description":"Pacing in small infants: limitations of transvenous pacing and epicardial pacing and some advantages of epicardial approach are discussed.","og_url":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2010-01-09T15:27:01+00:00","article_modified_time":"2023-11-18T11:20:06+00:00","author":"Johnson Francis","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Johnson Francis","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"Pacing in small infants","datePublished":"2010-01-09T15:27:01+00:00","dateModified":"2023-11-18T11:20:06+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/"},"wordCount":221,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/#primaryimage"},"thumbnailUrl":"","keywords":["button leads","button leads for epicardial pacing","epicardial pacing","screw in leads","steroid eluting leads"],"articleSection":["ECG \/ Electrophysiology"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/","url":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/","name":"Pacing in small infants - pros and cons of epicardial and transvenous","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/#primaryimage"},"thumbnailUrl":"","datePublished":"2010-01-09T15:27:01+00:00","dateModified":"2023-11-18T11:20:06+00:00","description":"Pacing in small infants: limitations of transvenous pacing and epicardial pacing and some advantages of epicardial approach are discussed.","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/#primaryimage","url":"","contentUrl":""},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/pacing-in-small-infants\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"Pacing in small infants"}]},{"@type":"WebSite","@id":"https:\/\/johnsonfrancis.org\/professional\/#website","url":"https:\/\/johnsonfrancis.org\/professional\/","name":"All About Cardiovascular System and Disorders","description":"","publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/johnsonfrancis.org\/professional\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec","name":"Johnson Francis","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","caption":"Johnson Francis"},"logo":{"@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g"},"description":"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal","url":"https:\/\/johnsonfrancis.org\/professional\/author\/jf\/"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/3629","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/comments?post=3629"}],"version-history":[{"count":4,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/3629\/revisions"}],"predecessor-version":[{"id":61416,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/3629\/revisions\/61416"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=3629"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=3629"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=3629"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}