{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:09:12Z","timestamp":1792109352642,"version":"4.4.0"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"abstract":"<jats:p>Congenital complete heart block (CCHB) is a rare condition that may lead to severe bradycardia and hemodynamic instability at birth, particularly in preterm infants with limited myocardial reserve. The use of transcutaneous pacing (TCP) in the delivery room has rarely been reported in neonates with CCHB, and extracorporeal membrane oxygenation (ECMO) during neonatal intensive care has sporadically been described. We report a preterm infant with antenatally diagnosed isolated CCHB who developed severe bradycardia and hemodynamic compromise immediately after birth despite adequate ventilation. Emergency TCP achieved prompt electrical capture and rapid hemodynamic stabilization in the delivery room. During attempted early permanent pacemaker implantation in the Neonatal Intensive Care Unit (NICU), the patient developed intraoperative cardiorespiratory arrest requiring venoarterial ECMO support and placement of a temporary epicardial pacing system. After myocardial recovery, a permanent pacemaker was successfully implanted, and the infant was discharged with normal ventricular function. TCP may provide rapid hemodynamic stabilization in the delivery room for neonates with life-threatening bradycardia due to CCHB, and it may serve as a bridge to more definitive pacing modalities. This case suggests that a stepwise stabilization approach may be considered in critically unstable neonates with CCHB, incorporating delivery-room transcutaneous pacing followed by extracorporeal support in the NICU to allow deferred definitive pacing. In selected critically unstable patients, ECMO may provide life-saving support during surgical intervention.<\/jats:p>","DOI":"10.1177\/19345798261459419","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:54:07Z","timestamp":1783907647000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Delivery-room transcutaneous pacing and ECMO support in the NICU for a preterm neonate with congenital complete heart block"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5224-6334","authenticated-orcid":false,"given":"Susana Elena","family":"Zeballos Sarrato","sequence":"first","affiliation":[{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"\u00c1lvarez Mart\u00edn","sequence":"additional","affiliation":[{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorotea","family":"Blanco Bravo","sequence":"additional","affiliation":[{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"S\u00e1nchez Luna","sequence":"additional","affiliation":[{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,12]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437597.44550.5d"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2019.101034"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1191\/0961203303lu408oa"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.29"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951121001220"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951122001706"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002469900466"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-005-2610-8"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12969-023-00920-w"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.5385\/nm.2016.23.4.223"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.11.022"},{"key":"e_1_3_6_13_2","first-page":"2050313X2412395","volume-title":"Anesthetic management of bed-to-bed surgery for epicardial pacemaker implantation in neonates with congenital complete heart block: Case report","author":"Sari EK","year":"2024","unstructured":"Sari EK, Alatas A, Kusuma H. Anesthetic management of bed-to-bed surgery for epicardial pacemaker implantation in neonates with congenital complete heart block: Case report. Sage Open Med Case Rep, 2024, vol 12, p. 2050313X241239525."},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.4103\/1658-354X.125977"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.04.019"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2005.01634.x"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3182196cb1"},{"key":"e_1_3_6_18_2","first-page":"1208","article-title":"A case of neonatal lupus presenting with myocardial dysfunction with complete heart block: early identification and management results in excellent outcome","volume":"12","author":"Ali M","year":"2025","unstructured":"Ali M, Beheri RM, Alheraish YA, et al. A case of neonatal lupus presenting with myocardial dysfunction with complete heart block: early identification and management results in excellent outcome. Int J Contemp Pediatr 2025; 12: 1208\u20131211. https:\/\/doi.org\/10.18203\/2349-3291.ijcp20251767","journal-title":"Int J Contemp Pediatr"}],"container-title":["Journal of Neonatal-Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19345798261459419","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19345798261459419","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19345798261459419","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:46:45Z","timestamp":1784036805000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19345798261459419"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,12]]},"references-count":17,"alternative-id":["10.1177\/19345798261459419"],"URL":"https:\/\/doi.org\/10.1177\/19345798261459419","relation":{},"ISSN":["1934-5798","1878-4429"],"issn-type":[{"value":"1934-5798","type":"print"},{"value":"1878-4429","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,12]]},"article-number":"19345798261459419"}}