During the past 11 years, 19 cases of pacemaker implantation in children were done at our clinic.
Indication for implantation were congenital A-V block 2, sick sinus syndrome 2, postoperative paroxysmal atrial tachycardia 1 and postoperative complete A-V block 14. Postoperative paroxysmal atrial tachycardia was terminated by right ventricular overdrive pacing (100/min). So bipolar endocardial lead was placed at right ventricular apex and high-frequency receiver was implanted at anterior upper chest. Complication were included as follows. Elevation of threshold in 5 cases, lead rupture in 3 cases, Twiddler's syndrome in one case, left ventricular rupture by screw type lead in one et al. During the surgery measurement of threshold of lead in the primary implantation and also at the time of generator change is very important to. prevent the exit block. Pacemaker was placed at retroperitoneal pocket. Six cases (31.6%) were died. Three cases were died from cardiac failure, two cases were from low cardiac output syndrome after cardiac operation and one case from sepsis. Other cases have been doing well under periodic check up at pacemaker clinic.