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(ST. LOUIS, MO) – June 28, 2004 – At less than four months of age, Damaris Ochoa is the youngest patient in the world to receive a pacemaker for resynchronization therapy. The device was implanted at St. Louis Children’s Hospital (SLCH).
Damaris Ochoa was born with congenital cardiomyopathy. The left ventricle – the main pumping chamber of the heart – was enlarged and underdeveloped. It could not pump enough blood and oxygen to meet the needs of the baby’s tiny body.
Typically, pacemakers are used to treat heartbeats that are too slow. In resynchronization therapy, a pacemaker is implanted to coordinate, or synchronize, the pattern of heart muscle contractions that comprise the normal heartbeat.
Hundreds of children in the United States might benefit from resynchronization therapy with pacemakers or from other treatments with implantable cardiac devices, but these therapies are predominantly used only in adults, according to Edward Rhee, M.D., director of electrophysiology and arrhythmia services at St. Louis Children’s Hospital and assistant professor of pediatrics at Washington University School of Medicine.
"In children with heart failure, the traditional primary treatments are medications and, in severe cases, heart transplant," Dr. Rhee said. "If a child with heart failure from any cause also has abnormal conduction, resynchronization therapy should be considered before transplant, which has many significant risks and complications. It’s always better if we can find treatments that will delay or avoid the need for transplant."
Modern advances in pacemaker technology and other implantable cardiac devices offer new and potentially life-saving treatments for some infants and children. In addition to resynchronization therapy with pacemakers, Dr. Rhee predicts an increase in the use of implantable cardioverter defibrillators (ICDs) in children. ICDs are devices that sense a dangerously fast heart rhythm called ventricular tachycardia (VT). VT can lead to ventricular fibrillation (VF), a condition in which the ventricles of the heart begin to quiver and no longer can pump the body’s blood supply. Without immediate emergency care, VF leads to sudden cardiac death (SCD) within minutes. ICDs sense the onset of VT or VF and deliver an electric shock to the heart that restores its normal rhythm. Modern devices combine both resynchronization pacing and emergency "rescue" defibrillation into a single unit.
According to Dr. Rhee, children and young adults who may benefit from these devices include many who have undergone heart surgeries, or who have certain congenital disorders that alter the normal electrical conduction system of the heart.
St. Louis Children's Hospital has provided specialized care for children for more than 125 years. Children's Hospital is affiliated with Washington University School of Medicine, ranked the second best medical school in the country by US News & World Report. Washington University is known for excellence in medical research, teaching and patient care. In 2003, Child magazine ranked St. Louis Children's Hospital sixth on its list of the 10 Best children's hospitals in the country, and fourth in neonatology/neonatal intensive care unit (NICU). St. Louis Children's Hospital also is a member of BJC HealthCare, the first fully integrated health-care system in the country to join an academic medical center with suburban, rural and metropolitan-based health-care facilities.
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