Andrew D. Blaufox, MD Pediatric Electrophysiology Schneider Children's Hospital . Associate Professor Clinical Pediatrics Albert Einstein College of Medicine. Medical School: Albert Einstein College of Medicine . Residency: Mount Sinai School ...
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Host: Do we have pacemakers in children? Andrew D. Blaufox: We do. Pacemakers in children is relatively rare. Children need pacemakers for several different reasons. Some children are born with something called complete heart block where the electrical signals from the top chamber of the heart cannot go down to the bottom chamber of the heart and the resulting heart rate is too slow and that is caused by a variety of different conditions, the most common thing is that some mothers may have something called systemic lupus and when this occurs, they form antibodies that cross the center and attack the child's electrical system and render it inefficient. Host: You made a good point because lupus picks up in arthritis, but it affects virtually every part of the body. Is that true? Andrew D. Blaufox: Absolutely and systemic lupus has the potential for affecting many, many organs and in this case even an unborn child. Other than the lupus patients who have complex congenital heart disease often undergo surgery and unfortunately as a consequence of surgery sometimes, patients also develop heart block and require a pacemaker. Host: The complete heart block without doing this will be the logic in a kid like that. Andrew D. Blaufox: It varies that some children can do a very well but there is a risk of dying suddenly, particularly, if they have associated heart disease, structural heart disease that is but there are several things that we need to keep in mind when evaluating a patient for a pacemaker and that is, what is their average heart rate? What is their lowest heart rate, are there any times where they are many seconds in between one impulse and the next? Do they have a Y complex escape meaning is the rhythm that's sustaining the heart coming from the bottom chamber or some where up higher in the normal electrical system and whether or not the child has any extra beats coming from the bottom chamber or PBCs? All those thing would put a patient at higher risk for developing a life threatening situation.

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