Transvenous pacing in pediatric patients.
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Biomedical subjects
Publications and source records attributed to C Shannon.
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The sick sinus syndrome is being recognized with increasing frequency in children. Although it is sometimes benign, it can be serious or have fatal consequences. Fifty-one patients (mean age 10.5 years) underwent permanent cardiac pacing for sick sinus syndrome. Twenty patients had epicardial ventricular pacing and 12 had an epicardial atrial implant. Seven had endocardial atrial pacing, six epicardial atrioventricular (AV) sequential pacing, four epicardial universal pacing and two endocardial universal pacing. Of the 49 symptomatic patients, 45 had relief of symptoms. Eleven of 18 patients with associated tachyarrhythmias had amelioration of their tachycardia. There were no early but two late deaths unrelated to the pacemakers. Seven patients during a mean follow-up period of 26 months required reoperation for pacing lead or sensing problems. Permanent pacing for sick sinus syndrome in children is a safe and symptomatically effective procedure.
We believe that improvements in pacing are such that no patient who has the slightest need for pacing should be denied. The type of pacemaker implanted should be based on the patient's needs and underlying electrophysiologic status.
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The nurse has an important role in assisting chronically ill patients disabled by breathlessness to adjust to long-term oxygen therapy. This article provides a simplified summary of the changed physiology necessitating additional oxygen. The focus, however, is on nursing and the educational and rehabilitation strategies that may be used to support patients in living with long-term oxygen therapy.
A program to improve the provision of health services to Aboriginals and Torres Strait Islanders will include a management training segment for the indigenous populations.
Training sessions to develop child protective workers' understanding of the problems that lead to burnout were judged effective by most of the participants.
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