{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:12:55Z","timestamp":1777878775230,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"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":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    Permanent pacing in the young pediatric population can be challenging, especially in small neonates. We describe our institutional experience with the surgical placement of dual-chamber permanent pacemaker (PPM) systems in neonates weighing &lt;3 kg at the time of implantation.\n                    <jats:bold>Methods:<\/jats:bold>\n                    The Cincinnati Children's Hospital database was used to identify patients who had an epicardial dual-chamber PPM and weighed &lt;3 kg at implantation from 2000 to 2022. Descriptive analyses focused on surgical techniques, postimplant complications, and survival.\n                    <jats:bold>Results:<\/jats:bold>\n                    Twenty patients underwent dual-chamber PPM implantation. Median age at implantation was 6.0 days [3.0-27.0], weight 2.6 kg [2.2-3.0], with the smallest being 1.9 kg. Eight of 20 patients (40%) were premature (&lt;37 weeks), and 2\/20 (10%) had Trisomy 21. Most implantations were via median sternotomy [17\/20 (85%)]. Most had generator placement in the left upper quadrant [13\/20 (65%)] above the posterior fascia and below the rectus muscle. Surgical indication for implantation was congenital heart block [18\/20 (90%)], of which 4\/18 (22%) were due to maternal lupus. Two patients had PPM secondary to postoperative heart block and 3\/20 (15%) had emergent temporary epicardial wires placed before PPM. Pacemaker-related complications occurred in 1\/20 (5%) patient on postoperative day 20 related to minor wound dehiscence, without infection, leading to a dual-chamber PPM exchange for a single-chamber device. Another patient (5%) developed a seroma requiring drainage on postoperative day 16. There were no PPM-related in-hospital mortalities or other complications, including late PPM infections.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Dual-chamber epicardial PM implantation in neonates &lt;3 kg is feasible with minimal complications and good outcomes based on our reported technique.\n                  <\/jats:p>","DOI":"10.1177\/21501351251345811","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T08:35:23Z","timestamp":1752222923000},"page":"46-51","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety and Feasibility of Implanting Dual-Chamber Permanent Pacemakers in Patients Under 3 kg"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8151-7391","authenticated-orcid":false,"given":"Hosam F.","family":"Ahmed","sequence":"first","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9980-0160","authenticated-orcid":false,"given":"Amir","family":"Mehdizadeh-Shrifi","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7236-5402","authenticated-orcid":false,"given":"Grant","family":"Chappell","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3178-7585","authenticated-orcid":false,"given":"Alan","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4112-9823","authenticated-orcid":false,"given":"Awais","family":"Ashfaq","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shankar","family":"Baskar","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L. S.","family":"Morales","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David G.","family":"Lehenbauer","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.12.098"},{"issue":"4","key":"e_1_3_3_3_2","first-page":"581","article-title":"Long-term outcome of transvenous pacemaker implantation in infants: a retrospective cohort study","volume":"19","author":"Vos LM","year":"2017","unstructured":"Vos LM, Kammeraad JAE, Freund MW, Blank AC, Breur J. Long-term outcome of transvenous pacemaker implantation in infants: a retrospective cohort study. Europace. 2017;19(4):581-587. doi:https:\/\/doi.org\/10.1093\/europace\/euw031","journal-title":"Europace."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht150"},{"issue":"3","key":"e_1_3_3_5_2","first-page":"85","article-title":"Congenital complete heart block: an international study of the natural history","volume":"4","author":"Micha\u00eblsson M","year":"1972","unstructured":"Micha\u00eblsson M, Engle MA. Congenital complete heart block: an international study of the natural history. 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ACC\/AHA\/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology\/American Heart Association task force on practice guidelines (writing committee to revise the ACC\/AHA\/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. 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