Heartbeat of hope: newborn's journey with a pacemaker

Congenital heart block is a rare disorder of neonates. It is generally diagnosed in the antenatal period or at birth and is commonly associated with transplacental passage of anti-Ro and/or anti-La antibodies to the fetus. It has a high mortality rate if left untreated. A pacemaker is considered as the treatment of choice, but the expertise for pacemaker implantation is available at only a few centres in India. We present a case of a late preterm neonate with antenatally diagnosed heart block due to anti-Ro antibody in the mother. The baby required delivery room resuscitation and mechanical ventilation. Postnatal ECG was also suggestive of third degree heart block and the baby landed into shock soon after birth. The baby was managed initially with ionotropic agents and an epicardial pacemaker was implanted within 6 hours of life. The baby was discharged successfully with stable vitals.