Initial experience with a new pacemaker therapy in newborn and infants

A small pulse-generator is important in prematures and young infants. Objectives: Analysis of our experience with the smallest currently availabl e pacemaker in the pediatric age group. Patients and methods: We report about the pacemaker therapy in two prematur e babies with symptomatic complete congenital AV-block and about an 8 year old boy with congenital AV-block and palliation of complex congenital heart disease by total cave pulmonary connection. The currently smallest pulse g enerator was implanted for the first time with a steroid eluting epicardial bipolar lead. Due to the 'autocapture algorithm' a smaller battery can be used with the same life span as a normal sized pulse generator. Results: A stable capture threshold with a high amplitude of the evoked res ponse signal and regular function of the 'autocapture' algorithm was docume nted during a followup of up to 1 year. This algorithm has been used so far only with endocardial leads. Conclusion:This new combination seems promising for pacemaker therapy in sm all children.