Tiny pacemaker, Norton Children’s Hospital surgeons save infant’s life

LOUISVILLE, Ky. (WAVE) - Pediatric specialists at Norton Children’s Heart Institute successfully implanted a tiny pacemaker into a baby who was born at 28 weeks gestation, believed to be the first surgery of its kind on a premature infant in the world.
It was decided by a multidisciplinary team at Norton Children’s Heart Institute because of the baby’s slow cardiac rate and congenital heart disease and complete atrioventricular block (CCAVB) that the newborn get the pacemaker. CCAVB affects one in every 22,000 newborns, and if left untreated, the disorder may lead to serious health problems or even death.
Typically, as soon as an infant with CCAVB is at least 4 1/2 to 5 1/2 pounds, a pacemaker can be implanted, according to information from Norton Healthcare. However, it is highly recommended that they be allowed to develop while receiving therapy so that the pacemaker can be properly inserted.
Because the child in Norton’s care was so small, the conventional strategy was not possible.
“In this instance, the patient was not of the optimal size and medical/conservative management was unsuccessful, so a specially modified pediatric-sized pacemaker also known as an implantable pulse generator (IPG) created by Medtronic was used,” Dr. Soham Dasgupta said.
According to Norton, Dasgupta and Dr. Christopher L. Johnsrude reviewed data from a procedure in which a similar tiny pediatric pacemaker had been implanted in a miniature pig with a heart similar to that of a child.
The 1.16 by 0.65 by 0.38-inch, 0.18-ounce device was implanted in the child during a two-hour open-heart operation.
“While the operative steps might be comparable to the usual pacemaker implantation surgery, this surgery was especially delicate due to the very small size of the baby,” Dr. Bahaaldin Alsoufi said.
According to Norton, the patient is doing well and is being cared for by cardiac and neonatal specialists.
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