Pacemaker implantation in a neonate with congenital complete heart block--a case report

Reported herein is our experience with pacemaker implantation in a neonate with complete AV block and without other concomitant cardiac anomalies. A male fetus exhibited an intrauterine heart block rate of about 40 beats per minute on the electrocardiogram. An emergency pacemaker implantation was attempted at birth by means of intravenous temporary pacing to relieve signs of congestive heart failure. On the 28th day of life, a myocardial electrode was fixed on the right ventricular wall and the generator was positioned on the left side of the subcutaneous abdominal wall. A technical device was designed by means of packing pacemaker wire in a loop-forming fashion with a silastic sheet and was made in such a way as to adjust with growth of the patient. During the 2 year follow-up period, this technique proved to be effective. Our experience also supports the contention that pacemaker implantation in the newborn is feasible and beneficial in the treatment of congenital complete AV block.