Renowned cardiologists feel that children fixed with epicardial pacemakers may incur coronary artery compression a little more frequently than earlier thought. A review of patient records at Boston Children's Hospital led to the suggestion of stringent scrutinizing to diagnose children in danger of developing complications. Their proposals were published in the journal HeartRhythm.

"Coronary artery compression is thought to be rare," explained lead investigator Douglas Y. Mah, MD, director of the Pacemaker and ICD Program in the Department of Cardiology, Boston Children's Hospital, and assistant professor of paediatrics, Harvard Medical School, Boston, MA, USA. "Its true incidence, however, may be higher than we believed due either to a lack of awareness or lack of reporting in the literature."

A child with an epicardial pacemaker suddenly died due to coronary artery compression. This incited doctors to augment scrutiny of all children having epicardial pacing or defibrillation systems. They reassessed the data of all patients visiting Boston Children's Hospital from 2000 - 2017 who had functioning or deserted epicardial wires via coronary imaging. Eight out of 145 patients presented with certain levels of coronary compression caused by the epicardial leads. Consequently, seven patients had their epicardial leads surgically removed or repositioned.

This study offers an agenda for supervising patients with epicardial pacemakers or defibrillators and spotting those who may require modification or exclusion of their epicardial wires.

"The use of pacemakers and defibrillators in children is growing," noted Dr. Mah. "As more epicardial devices are implanted, more children may be at risk for developing coronary compression from their leads. We hope to increase awareness among healthcare providers and patients of this important, possibly preventable, and potentially fatal complication and provide a useful screening algorithm to detect at-risk patients and ultimately prevent complications."