{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:16:55Z","timestamp":1792268215828,"version":"4.4.0"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Congenital complete atrioventricular (AV) block is a rare but potentially fatal condition in neonates, especially those with extremely low birth weight (ELBW). Management in this population is challenging due to technical limitations and high comorbidity risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We report the case of a female infant born at 25\u2009+\u20092 weeks' gestation, weighing 740\u2005g, with immune-mediated congenital complete AV block. Temporary epicardial pacing was initiated on day one due to persistent bradycardia and hemodynamic compromise. A dual-electrode strategy with alternating pacing sites maintained low thresholds for 90 days. A permanent pacemaker was implanted at 2,890\u2005g. Despite complications including hydrops fetalis, intraventricular hemorrhage, hydrocephalus, and intestinal perforation, the patient was discharged in good condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case demonstrates the feasibility of staged pacemaker implantation in ELBW infants and supports individualized pacing strategies to optimize outcomes in this vulnerable population.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1626650","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T05:36:59Z","timestamp":1752644219000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Staged epicardial pacemaker implantation in a 740\u2005g ELBW infant with 25\u2009+\u20092 weeks of GA with congenital complete heart block"],"prefix":"10.3389","volume":"13","author":[{"given":"Tamari","family":"Tvildiani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Riedl-Seifert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Waitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Dimpfl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Jenke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"B1","first-page":"36","article-title":"A review of congenital heart block","volume":"5","author":"Friedman","year":"2003","journal-title":"Images Paediatr Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2098","DOI":"10.1111\/j.1540-8159.1997.tb03636.x","article-title":"Natural history of congenital complete atrioventricular block","volume":"20","author":"Michaelsson","year":"1997","journal-title":"Pacing Clin Electrophysiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1038\/sj.jp.7211038","article-title":"Congenital complete heart block: fetal management protocol, review of the literature, and report of the smallest successful pacemaker implantation","volume":"24","author":"Donofrio","year":"2004","journal-title":"J Perinatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.hrthm.2016.10.017","article-title":"Risk factors for complications in the implantation of epicardial pacemakers in neonates and 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atrioventricular block","volume":"2","author":"Filippi","year":"2007","journal-title":"Congenit Heart Dis"},{"key":"B8","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1055\/s-2002-23965","article-title":"Transthoracic pacing in a very low birth weight infant with congenital complete atrioventricular block","volume":"214","author":"N\u00fcrnberg","year":"2002","journal-title":"Klin Padiatr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"92","DOI":"10.24509\/jpccs.23-017","article-title":"Successful pacemaker implantation for congenital complete heart block with pulmonary valve stenosis in an extremely low birth weight infant","volume":"8","author":"Kato","year":"2024","journal-title":"J Pediatr Cardiol Card Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2285","DOI":"10.1111\/jocs.12824","article-title":"Management of congenital complete heart block in a low-birth-weight infant","volume":"36","author":"Nakanishi","year":"2021","journal-title":"J Card Surg"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1626650\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T05:37:00Z","timestamp":1752644220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1626650\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,16]]},"references-count":10,"alternative-id":["10.3389\/fped.2025.1626650"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1626650","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,16]]},"article-number":"1626650"}}