{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T09:04:18Z","timestamp":1766394258126,"version":"3.48.0"},"reference-count":11,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Advances in pediatric electrophysiology have revolutionized cardiac care by offering patients treatments for increasingly complex cardiac rhythm and conduction disorders. However, despite these innovations, there are a number of potential complications that clinicians have to deal with. Case presentation: This clinical case study describes a rare complication in a child following pacemaker implantation, namely the appearance and accumulation of air in the pacemaker pocket. The child underwent multiple cardiac surgery for a complex congenital heart defect (CHD). Unfortunately, during surgical repair of a ventricular septal defect, the conduction pathways were disturbed. This caused second-degree atrioventricular block and required implantation of an epicardial pacemaker system. Heart block developed several days postoperatively and the child underwent a series of diagnostic tests and was successfully treated. Discussion: Pneumothorax and pneumomediastinum with air dissemination into the pacemaker pocket may develop postoperatively. But this a rare complication of pacemaker implantation, especially in children. This complication can cause pacemaker malfunction and be life-threatening. In the presented clinical case, the most likely cause was spontaneous pneumothorax expanding to the mediastinum and into the pacemaker pocket. Conclusions: Early identification of this complication will minimize the risk of pacemaker dysfunction and improve clinical outcomes.<\/jats:p>","DOI":"10.3390\/children13010018","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T08:35:27Z","timestamp":1766392527000},"page":"18","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Air Entrapment in a Pacemaker Pocket in a Child"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4683-1454","authenticated-orcid":false,"given":"Vitaliy V.","family":"Suvorov","sequence":"first","affiliation":[{"name":"Department of Surgical Diseases of Children, Saint-Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0060-4168","authenticated-orcid":false,"given":"Dmitri O.","family":"Ivanov","sequence":"additional","affiliation":[{"name":"Department of Surgical Diseases of Children, Saint-Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","first-page":"23","article-title":"Special problems of pacing in children","volume":"3","author":"Antretter","year":"2003","journal-title":"Indian Pacing Electrophysiol. J."},{"key":"ref_2","first-page":"104","article-title":"Temporary biventricular pacing after cardiac surgery: A method of supporting cerebral perfusion","volume":"5","author":"Naumov","year":"2014","journal-title":"Pediatrician"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1111\/pace.14584","article-title":"Inappropriate shocks due to air entrapment in patients with subcutaneous implantable cardioverter-defibrillator: A meta-summary of case reports","volume":"10","author":"Iavarone","year":"2022","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"32","DOI":"10.35336\/VA-2022-1-05","article-title":"Permanent pacing in children: Results of follow-up, assessment of complications","volume":"29","author":"Dzhaffarova","year":"2022","journal-title":"J. Arrhythmol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Schiariti, M., Cacciola, M., and Puddu, P.E. (2011). Complications of Pacemaker Implantation, Modern Pacemakers: Present and Future, IntechOpen.","DOI":"10.5772\/13446"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"174","DOI":"10.29001\/2073-8552-2023-38-2-174-179","article-title":"Complications of permanent pacing in children depending on the method of implantation","volume":"38","author":"Kartofeleva","year":"2023","journal-title":"Sib. J. Clin. Exp. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Lo, S.-W., and Chen, J.-Y. (2022). Case report: A rare complication after the implantation of a cardiac implantable electronic device: Contralateral pneumothorax with pneumopericardium and pneumomediastinum. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.938735"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1016\/j.hrthm.2017.07.024","article-title":"Incidence, predictors, and outcomes associated with pneumothorax during cardiac electronic device implantation: A 16-year review in over 3. 7 million patients","volume":"14","author":"Ogunbayo","year":"2017","journal-title":"Heart Rhythm"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/j.cjco.2025.07.004","article-title":"Pacemaker Failure to Capture Caused by a Pneumothorax","volume":"7","author":"Singh","year":"2025","journal-title":"CJC Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1093\/europace\/euac046","article-title":"Air entrapment as a potential cause of early subcutaneous implantable cardioverter defibrillator malfunction: A systematic review of the literature","volume":"24","author":"Ali","year":"2022","journal-title":"Europace"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1378\/chest.82.5.651","article-title":"Pacemaker system failure secondary to air entrapment within the pulse generator pocket. A complication of subclavian venipuncture for lead placement","volume":"82","author":"Hearne","year":"1982","journal-title":"Chest"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/1\/18\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T09:00:24Z","timestamp":1766394024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/1\/18"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,22]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["children13010018"],"URL":"https:\/\/doi.org\/10.3390\/children13010018","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,22]]}}}