More frequent chest x-ray screenings of children with epicardial pacemakers may help identify those at risk of coronary artery compression, according to the authors of a study published online Aug. 13 in HeartRhythm.
The researchers reviewed records from 145 patients treated at Boston Children’s Hospital from 2000 through 2017 who had epicardial leads and underwent either catheter angiography or CT. Eight of them (5.5 percent) showed evidence of coronary artery compression, with six exhibiting symptoms—one sudden death, three with chest pain and two with unexplained fatigue. The seven surviving patients required surgery to reposition their lead.
Considering the position of pacemaker wires may shift as the child grows, lead author Douglas Mah, MD, and colleagues recommended chest x-rays be taken every few years.
“Chest radiography can serve as a good surveillance tool, with cine CT scans considered in those with concerning radiographs or with symptoms,” wrote Mah, the director of the Pacemaker and ICD Program at Boston Children’s, and coauthors. “Confirmatory (catheter angiography) can be performed before surgical intervention.”
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Daniel joined TriMed’s Chicago editorial team in 2017 as a Cardiovascular Business writer. He previously worked as a writer for daily newspapers in North Dakota and Indiana.