A new study suggests that wireless pacemakers could be a safe and effective short-term option for children with slow heartbeats.
As per US News, children with bradycardia, an abnormally slow heart rate, require a pacemaker to keep their hearts beating normally. According to a new report in the journal Circulation: Arrhythmia and Electrophysiology, researchers successfully implanted wireless pacemakers in 62 children to determine if the cutting-edge devices could be used safely in children.
“Lead-free pacemaker technology is the wave of the future,” said Dr. Maully Shah, director of cardiac electrophysiology at Children’s Hospital of Philadelphia’s Cardiac Center.
In a news release from the journal, Shah stated, “This is an excellent technology that could be made available to a larger pediatric population.” “However, techniques and tools to place the device must be designed for smaller patients, particularly children, and there must be a way to remove and replace this pacemaker without surgery when the battery runs out, as pediatric patients will likely require pacing for the remainder of their lives.”
Traditional pacemaker devices are implanted outside the heart, with electrical leads running into the heart through the veins. These wires transmit electrical pulses that assist the heart in maintaining a normal pulse rate.
Wireless pacemakers are a more recent development. They are the size of a AAA battery, which is roughly 90 percent smaller than conventional pacemakers. A catheter is used to implant these tiny capsule-like devices directly into one of the heart’s chambers. Due to its location within the heart, the device does not require wires to deliver electrical pulses.
These wireless devices offer children distinct benefits. Because there are no wires, they do not have to limit their upper body movement for fear of jarring a wire loose or breaking it. The authors of the study noted that implanting a wireless pacemaker requires a catheter that is too large for use in children.
The researchers evaluated the implantation of wireless pacemakers in 63 children aged 4 to 21 at 15 medical centers in the United States, United Kingdom, and Italy between 2016 and 2021 for the purpose of this study. The pacemaker was the first for 77% of the children.
The implant was successful in 62 of 63 children, and the patient’s heartbeat stabilized within 24 hours, despite the fact that adult-sized catheters were used to deliver the implant. During an average of 10 months of follow-up, the pacemakers remained functional. According to the researchers, pacemaker batteries typically last between five and ten years, depending on how frequently the device must deliver pulses to maintain a steady heart rhythm.
According to the report, ten of the children experienced complications after receiving the pacemaker. There were three major complications: a blood clot in a patient’s femoral vein, a patient whose heart was torn during the procedure, and a pacemaker that had to be removed after one month due to suboptimal performance.
“Using catheter-guided delivery systems designed for adults in children is difficult and may increase the risk of serious complications. Since these are large catheters, it is crucial to select patients according to their size. “Two of the three complications occurred in patients weighing less than 30 kilograms,” explained Dr. Shah.
“The femoral vein in the groin is the traditional placement site for a leadless pacemaker,” continued Shah. For some patients, particularly younger and smaller children, the jugular vein (in the neck) provided a more direct route for implanting the tiny pacemaker in a smaller heart. The investigators intend to monitor the children for an additional five years to ensure that the pacemakers continue to treat their slow heartbeat safely and effectively.
