Perinatal multidisciplinary management for neonates with prenatally-diagnosed congenital complete heart block undergoing early epicardial pacemaker implantation: a retrospective single-center case series.
Huiyan Cang, Guangzhi Jia, Di Zhang et al.
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Case in brief
This retrospective single-center series described four neonates with prenatally diagnosed isolated congenital complete heart block who required early epicardial pacemaker implantation. All were delivered by cesarean section and had a heart rate below 50 bpm at birth, prompting immediate vasoactive resuscitation. Umbilical venous catheterization was achieved rapidly in each infant. All underwent successful permanent pacemaker implantation within 10 days, with improved cardiac function, and were discharged home. One infant was readmitted 8 days after discharge with a pacemaker-pocket infection and died on postnatal day 46.
What made this case unusual
The series highlights the immediate perinatal instability of prenatally identified cases: every neonate had a heart rate below 50 bpm at birth and required vasoactive resuscitation, despite planned multidisciplinary care.
Diagnostic / clinical pearl
Prenatal recognition of isolated congenital complete heart block allows coordinated delivery-room preparation, including rapid umbilical venous access and individualized vasoactive support, while arranging early epicardial pacing.
Why it matters
The pocket infection and subsequent death in one infant underscore that successful implantation and initial discharge do not eliminate the need to monitor for postoperative complications.