Pacing threshold spikes months and years after implant.

To determine patterns of variation in chronic pacing thresholds, we made 4,942 threshold measurements in 257 patients with 312 leads, at times from implant to 295 months (median 17 months) including 1,053 determinations in 46 children less than 12 years old. Motivation was late sudden death in two single-ventricle pacemaker-dependent children with multiple possible death causes. At stimulus duration 0.

Complete transposition of the great arteries: treatment in the current era.

Transposition of the great arteries usually can be diagnosed by fetal echocardiography, which is important because the arterial switch operation, currently the treatment of choice, must be performed very early in life. The results of the arterial switch operation have been good to date. The dilemma remains, however, whether a fetus in whom a diagnosis of transposition is made should be aborted or treated surgically soon after delivery.

Corrective repair of complete atrioventricular canal defects and major associated cardiac anomalies.

Twenty-nine patients with balanced forms of complete atrioventricular (AV) canal defects and tetralogy of Fallot in 12, double-outlet right ventricle (DORV) in 10, and additional anomalies associated with atrial isomerism in 7 underwent corrective repair. Age ranged from 39 days to 24 years (median, 3.7 years).