the best option?

Which of the dual chamber rate responsive pacemaker would be best for an 8 year old child from following perspectives: Restoration of physiology, longevity and the size of the scar and bulge! She has had a medtronic, epicardiac, single chamber rate responsive, kappa device 6 yrs ago.which now needs to be replaced by a dual chamber device. I am afraid doctors may have proprietary interests that dictates their choice.

3 Comments

The Best PM For Your Child

by SMITTY - 2012-03-11 01:03:21


Hello Tinu,

If this were my great grandchild (I have 2 about this age) I would discuss with their Dr exactly what you have posted here with the exception of asking if the Dr has a proprietary interest in the PM they think is best. A Dr worth being called a Dr will put the patients best interest at the forefront. If I thought they weren't it would be down the road I go as quickly as possible.

I see Snitch has recommended a particular PM made by Sorin. Your child currently has a Medtronic PM. I don't say you should not discuss the PM recommended by Snitch with the Dr, but I would just ask the Dr's opinion of the unit. Not all Dr's offices are setup to do checkups on all makes of PMs. Also I would not want to be in the position of recommending a make of PM with which the Dr is not familiar. Anyway, I am told Medtronic is the world's largest maker of PMs so I would think they would have something comparable to the Sorin unit. Then, of course there is the possibility your child needs a PM that can do things of which you are not aware. All the more reason to discuss this matter with the Dr.

I wish your child the best,

Smitty

No...

by golden_snitch - 2012-03-11 03:03:48

Hi again!

I probably didn't make that clear enough, but my pacemaker, which is a Sorin Reply, is no choice for the kid as it has a dual sensor rate response with the minute ventilation sensor that does not work in kids. So, if I recommended any model, then Medtronic's Adapta, because of the high max. heart rate setting of 220bpm.

And no, Smitty, Medtronic does not longer make pacemakers with dual sensor rate response. That's why I switched from Medtronic to Sorin. My first pacer was an old Medtronic Kappa 401SR, and that was the last model Medtronic made with a dual sensor rate response.

Best
Inga

Rate response

by golden_snitch - 2012-03-11 11:03:58

Hi!

Well, actually there is not much choice for kids. The best rate responsive pacers have two sensors for the rate response: minute ventilation + accelerometer. However, my pacer manufacturer has told me that the minute ventilation sensor is just not made for kids, because they breath differently - I guess, faster - than adults, and the minute ventilation sensor would not react adequately to that. I asked, because I thought the pacer I have, a Sorin Reply DR, is perfect for kids: It's the world's smallest dual-chamber pacer and has a good rate response. But again, the answer I got was that minute ventilation won't work well in kids.

So, since you don't have the sensor choice, I'd go for a pacer with a high maximum heart rate/tracking rate. The one with the highest is Medtronic's Adapta as far as I know. It's upper rate limit is 220bpm while many other pacer models only do around 170-180bpm. Since kids have and need higher heart rates than adults, especially when exercising, the upper rate should be something to consider.

Hope this helps a bit.
Best wishes
Inga

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I finished 29th in London in 2 hours 20 minutes 30 seconds which is my fastest with or without a device so clearly it didn’t slow me down ! I had no problems apart from some slight chaffing on my scar - more Vaseline next time.