Abstract
Temporary epicardial cardiac pacing in patients with bradyarrhythmias may be used as a bridge to implantation of a permanent pacemaker. The temporary epicardial lead placement may sometimes necessitate a sternotomy that may pose a challenge in patients who have had multiple earlier sternotomies. The difficulty in accessing the epicardium for urgent implantation of temporary epicardial pacing leads depends on the extent of adhesions in such patients. We report an 8-year-8-month-old girl with a pacemaker with an extruded pulse generator and difficult myocardial access due to 5 prior transsternal procedures. The child presented to a tertiary care hospital in Muscat, Oman, in 2021. A trouble-shooting technique was adopted to achieve temporary epicardial pacing to provide time for a course of antibiotic therapy administration. A permanent transvenous pulse generator system was implanted after 7 days of temporary pacing.
Publication details
- DOI
- 10.18295/squmj.12.2023.079
- Journal
- Sultan Qaboos University Medical Journal, 23(5), 55-58
- Publisher
- Sultan Qaboos University
- Open access
- Gold open access
- License
- CC BY-ND 4.0
Cite this article
APA 7
Maddali, M. M., Al-Abri, I. A., Patel, M. H., Abokwafa, A. M., & Zacharias, S. (2025). Troubleshooting During Temporary Epicardial Lead Implantation in a Child with an Erosive Twiddler’s Syndrome and Multiple Sternotomies. Sultan Qaboos University Medical Journal, 23(5), 55-58. https://doi.org/10.18295/squmj.12.2023.079
MLA 9
Maddali, Madan M., et al. "Troubleshooting During Temporary Epicardial Lead Implantation in a Child with an Erosive Twiddler’s Syndrome and Multiple Sternotomies." Sultan Qaboos University Medical Journal, vol. 23, no. 5, 2025, pp. 55-58. https://doi.org/10.18295/squmj.12.2023.079.
Chicago (author–date)
Maddali, Madan M., Ismail A. Al-Abri, Malay H. Patel, Amr M. Abokwafa, and Sunny Zacharias. 2025. "Troubleshooting During Temporary Epicardial Lead Implantation in a Child with an Erosive Twiddler’s Syndrome and Multiple Sternotomies." Sultan Qaboos University Medical Journal 23 (5): 55-58. https://doi.org/10.18295/squmj.12.2023.079.
Harvard
Maddali, M. M., Al-Abri, I. A., Patel, M. H., Abokwafa, A. M. and Zacharias, S. (2025) 'Troubleshooting During Temporary Epicardial Lead Implantation in a Child with an Erosive Twiddler’s Syndrome and Multiple Sternotomies', Sultan Qaboos University Medical Journal, 23(5), pp. 55-58. doi:10.18295/squmj.12.2023.079.
Vancouver
Maddali MM, Al-Abri IA, Patel MH, Abokwafa AM, Zacharias S. Troubleshooting During Temporary Epicardial Lead Implantation in a Child with an Erosive Twiddler’s Syndrome and Multiple Sternotomies. Sultan Qaboos University Medical Journal. 2025;23(5):55-58. doi:10.18295/squmj.12.2023.079
IEEE
M. M. Maddali, I. A. Al-Abri, M. H. Patel, A. M. Abokwafa, and S. Zacharias, "Troubleshooting During Temporary Epicardial Lead Implantation in a Child with an Erosive Twiddler’s Syndrome and Multiple Sternotomies," Sultan Qaboos University Medical Journal, vol. 23, no. 5, pp. 55-58, 2025, doi: 10.18295/squmj.12.2023.079.