CASE REPORT article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1626650
This article is part of the Research TopicAdvances and Challenges in Neonatal Surgery: Congenital and Acquired ConditionsView all 19 articles
Staged Epicardial Pacemaker Implantation in a 740 g ELBW Infant with 25+2 Weeks of GA With Congenital Complete Heart Block
Provisionally accepted
- 1Department of Cardiac Surgery, Klinikum Kassel, Kassel, Germany
- 2Department of General Paediatrics and Neonatology, Klinikum Kassel, Kassel, Germany
- 3Department of Obstetrics and Gynaecology, Klinikum Kassel, Kassel, Germany
- 4University of Witten/Herdecke, Department of Pediatrics, Faculty of Health, Witten, Germany, Witten, Germany
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Background: Congenital complete atrioventricular (AV) block is a rare but potentially fatal condition in neonates, especially those with extremely low birth weight (ELBW).Management in this population is challenging due to technical limitations and high comorbidity risk.We report the case of a female infant born at 25+2 weeks' gestation, weighing 740 g, with immune-mediated congenital complete AV block.Temporary epicardial pacing was initiated on day one due to persistent bradycardia and hemodynamic compromise. A dual-electrode strategy with alternating pacing sites maintained low thresholds for 90 days. A permanent pacemaker was implanted at 2890 g. Despite complications including hydrops fetalis, intraventricular hemorrhage, hydrocephalus, and intestinal perforation, the patient was discharged in good condition.This case demonstrates the feasibility of staged pacemaker implantation in ELBW infants and supports individualized pacing strategies to optimize outcomes in this vulnerable population.
Keywords: Heart Block, pacemaker, premature infant, Autoimmune etiology, extremely low birth weight (ELBW) infant
Received: 11 May 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Tvildiani, Riedl-Seifert, Waitz, Dimpfl, Paul and Jenke. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Andreas Jenke, University of Witten/Herdecke, Department of Pediatrics, Faculty of Health, Witten, Germany, Witten, Germany
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