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Background <p>Congenital complete atrioventricular block (CCAVB) in preterm low birth weight neonates poses significant technical challenges for permanent pacemaker implantation. Epicardial pacing is generally preferred in this population; however, definitive implantation in infants weighing &lt; 2500&#xa0;g may be technically demanding. We evaluated the feasibility and safety of dual-chamber epicardial pacing in preterm low birth weight neonates with autoimmune-associated CCAVB.</p> Methods <p>Eight preterm neonates weighing &lt; 2500&#xa0;g underwent epicardial pacing between April 2021 and May 2022. All patients initially received temporary epicardial pacing via a subxiphoid approach for rhythm stabilization. Permanent dual-chamber epicardial pacemaker implantation was subsequently performed following clinical optimization and weight gain. Procedural outcomes, pacing performance, ventricular function, and device-related complications were analyzed descriptively.</p> Results <p>Temporary pacing was successfully established in all patients at a median postnatal age of 3 days (range, 0–12 days) and a median body weight of 2290&#xa0;g (range, 1890–2440&#xa0;g), without major complications. Permanent dual-chamber implantation was achieved in all cases at a median age of 18 days and a mean body weight of 2725&#xa0;g. Electrical parameters, including sensing amplitudes and capture thresholds, remained stable throughout follow-up. One patient required ventricular lead repositioning due to persistent ventricular dysfunction, with subsequent functional improvement, while ventricular function remained stable or improved in the remaining patients. No device-related complications were observed during the follow-up period. The median follow-up duration was 24 months.</p> Conclusions <p>This study indicates that dual-chamber epicardial pacing is feasible and safe in selected preterm low birth weight neonates with CCAVB. When immediate permanent implantation is technically challenging, a staged approach may facilitate stabilization and subsequent definitive implantation with favorable early to short-term outcomes.</p>

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Dual-chamber epicardial pacing in preterm and low birth weight infants with congenital complete atrioventricular block: a staged approach

  • 期刊论文

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  • 发表日期：

    2026年5月3日

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  • Ahmet Kuddusi İrdem,
  • Yiğit Kılıç,
  • Hasan Balık,
  • Onur Doyurgan

摘要

Background

Congenital complete atrioventricular block (CCAVB) in preterm low birth weight neonates poses significant technical challenges for permanent pacemaker implantation. Epicardial pacing is generally preferred in this population; however, definitive implantation in infants weighing < 2500 g may be technically demanding. We evaluated the feasibility and safety of dual-chamber epicardial pacing in preterm low birth weight neonates with autoimmune-associated CCAVB.

Methods

Eight preterm neonates weighing < 2500 g underwent epicardial pacing between April 2021 and May 2022. All patients initially received temporary epicardial pacing via a subxiphoid approach for rhythm stabilization. Permanent dual-chamber epicardial pacemaker implantation was subsequently performed following clinical optimization and weight gain. Procedural outcomes, pacing performance, ventricular function, and device-related complications were analyzed descriptively.

Results

Temporary pacing was successfully established in all patients at a median postnatal age of 3 days (range, 0–12 days) and a median body weight of 2290 g (range, 1890–2440 g), without major complications. Permanent dual-chamber implantation was achieved in all cases at a median age of 18 days and a mean body weight of 2725 g. Electrical parameters, including sensing amplitudes and capture thresholds, remained stable throughout follow-up. One patient required ventricular lead repositioning due to persistent ventricular dysfunction, with subsequent functional improvement, while ventricular function remained stable or improved in the remaining patients. No device-related complications were observed during the follow-up period. The median follow-up duration was 24 months.

Conclusions

This study indicates that dual-chamber epicardial pacing is feasible and safe in selected preterm low birth weight neonates with CCAVB. When immediate permanent implantation is technically challenging, a staged approach may facilitate stabilization and subsequent definitive implantation with favorable early to short-term outcomes.