A New Look for Micra: Epicardial Use of a Modified Micra-Based Pediatric IPG in a Neonate With Complete Heart Block

Severe bradycardia due to advanced atrioventricular (AV) block in neonates is rare but can be life-threatening, requiring urgent pacing. In the smallest infants, transvenous pacing is not feasible, and epicardial systems remain the standard. However, the pacemaker size still remains a significant issue in these small patients. Herein, we report the case of a premature neonate with complete intrauterine atrioventricular block successfully treated with an epicardial system using a custom-designed Micra-based Pediatric implantable pulse generator (IPG) connected to a standard epicardial lead.