Case Report: Staged epicardial pacemaker implantation in a 740 g ELBW infant with 25 + 2 weeks of GA with congenital complete heart block
BackgroundCongenital 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.Case presentationWe report the...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1626650/full |
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| author | Tamari Tvildiani Teresa Riedl-Seifert Markus Waitz Thomas Dimpfl Thomas Paul Andreas Jenke Andreas Jenke |
| author_facet | Tamari Tvildiani Teresa Riedl-Seifert Markus Waitz Thomas Dimpfl Thomas Paul Andreas Jenke Andreas Jenke |
| author_sort | Tamari Tvildiani |
| collection | DOAJ |
| description | BackgroundCongenital 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.Case presentationWe 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 2,890 g. Despite complications including hydrops fetalis, intraventricular hemorrhage, hydrocephalus, and intestinal perforation, the patient was discharged in good condition.ConclusionThis case demonstrates the feasibility of staged pacemaker implantation in ELBW infants and supports individualized pacing strategies to optimize outcomes in this vulnerable population. |
| format | Article |
| id | doaj-art-1cc8b4a98ee74ca7abf00d3b3387449a |
| institution | DOAJ |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-1cc8b4a98ee74ca7abf00d3b3387449a2025-08-20T02:40:29ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-07-011310.3389/fped.2025.16266501626650Case Report: Staged epicardial pacemaker implantation in a 740 g ELBW infant with 25 + 2 weeks of GA with congenital complete heart blockTamari Tvildiani0Teresa Riedl-Seifert1Markus Waitz2Thomas Dimpfl3Thomas Paul4Andreas Jenke5Andreas Jenke6Department of Cardiac Surgery, Hospital Kassel, Kassel, GermanyDepartment of Neonatology and Paediatric Gastroenterology, Children's Hospital Kassel, Kassel, GermanyDepartment of Neonatology and Paediatric Gastroenterology, Children's Hospital Kassel, Kassel, GermanyDepartment of Obstetrics and Gynaecology, Hospital Kassel, Kassel, GermanyDepartment of Neonatology and Paediatric Gastroenterology, Children's Hospital Kassel, Kassel, GermanyDepartment of Neonatology and Paediatric Gastroenterology, Children's Hospital Kassel, Kassel, GermanyDepartment of Pediatrics, Faculty of Health, University of Witten/Herdecke, Witten, GermanyBackgroundCongenital 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.Case presentationWe 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 2,890 g. Despite complications including hydrops fetalis, intraventricular hemorrhage, hydrocephalus, and intestinal perforation, the patient was discharged in good condition.ConclusionThis case demonstrates the feasibility of staged pacemaker implantation in ELBW infants and supports individualized pacing strategies to optimize outcomes in this vulnerable population.https://www.frontiersin.org/articles/10.3389/fped.2025.1626650/fullheart blockpacemakerpremature infantautoimmune etiologyextremely low birth weight (ELBW) infant |
| spellingShingle | Tamari Tvildiani Teresa Riedl-Seifert Markus Waitz Thomas Dimpfl Thomas Paul Andreas Jenke Andreas Jenke Case Report: Staged epicardial pacemaker implantation in a 740 g ELBW infant with 25 + 2 weeks of GA with congenital complete heart block Frontiers in Pediatrics heart block pacemaker premature infant autoimmune etiology extremely low birth weight (ELBW) infant |
| title | Case Report: Staged epicardial pacemaker implantation in a 740 g ELBW infant with 25 + 2 weeks of GA with congenital complete heart block |
| title_full | Case Report: Staged epicardial pacemaker implantation in a 740 g ELBW infant with 25 + 2 weeks of GA with congenital complete heart block |
| title_fullStr | Case Report: Staged epicardial pacemaker implantation in a 740 g ELBW infant with 25 + 2 weeks of GA with congenital complete heart block |
| title_full_unstemmed | Case Report: Staged epicardial pacemaker implantation in a 740 g ELBW infant with 25 + 2 weeks of GA with congenital complete heart block |
| title_short | Case Report: Staged epicardial pacemaker implantation in a 740 g ELBW infant with 25 + 2 weeks of GA with congenital complete heart block |
| title_sort | case report staged epicardial pacemaker implantation in a 740 g elbw infant with 25 2 weeks of ga with congenital complete heart block |
| topic | heart block pacemaker premature infant autoimmune etiology extremely low birth weight (ELBW) infant |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1626650/full |
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