he frequency and structure of complications of surgical treatment of atrioventricular block in children

Aim: to carry out a retrospective analysis of the frequency and structure of complications of surgical treatment of atrioventricular block in children treated at the RSPC of pediatric surgery in the period from 2012 to 2023 and to study the effectiveness of the algorithm of surgical treatment of atrioventricular block (AV block) to prevent postoperative complications associated with the implantation of an electrocardiostimulator.
Materials and methods. The analysis of the frequency and structure of complications of surgical treatment of AV block in children was carried out by retrospectively examining the medical records of 272 patients who underwent implantation of an electrocardiostimulator (ECS) in the RSPC for Pediatric Surgery in the period from 2012 to 2023.
Results and discussion. It was noted that the frequency of all postoperative complications associated with the implantation of the ECS was 18.7%. In the structure of complications, the most frequent were: electrode dysfunction requiring its replacement (80.2%), infectious complications (9.6%), ECS-induced cardiomyopathy (7.7%). Electrode dysfunction occurred 2.1 times more often with endocardial access. Epicardial right ventricular stimulation increased the risk of developing ECS-induced cardiomyopathy. Since 2018, using the algorithm of surgical treatment of AV block developed by us, the overall frequency of postoperative complications in children has decreased from 22% to 15%, i.e. by 1.5 times, and the risk of developing ECS-induced cardiomyopathy with epicardial stimulation has been eliminated.
Conclusion. The analysis showed that pacing in children is associated with a high risk of complications. Their frequency and structure depend on the correct access, taking into account the patient’s weight and the focus of stimulation. The use of the algorithm of surgical treatment of AV block in children developed by us reduces the overall frequency of postoperative complications and the risk of developing ECS-induced cardiomyopathy.

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