Heart rhythm : the official journal of the Heart Rhythm Society
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To examine outcomes of children with pacemakers over a 22-year period and identify risk factors for lead failure. ⋯ Pediatric pacing patients have a high incidence lead failures. These occur most commonly in younger patients, structural congenital heart disease, and those with epicardial lead systems. Approaches to pacing system implantation and follow-up in these patients need to be individualized, with special attention to minimizing risk of lead failures. Our findings suggest that expanded utilization of transvenous systems in smaller patients seems justified when anatomy permits.