Use of a Leadless pacemaker adapted as a generator for epicardial pacing in a preterm neonate with Sjögren's-syndrome-related antigen A-mediated carditis and congenital heart block

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Congenital heart block and carditis (n=1). Intervention: Medtronic MICRA implantable pulse generator adapted for epicardial application.

Q: What does this research mean for the field?

The Medtronic MICRA leadless pacing system can be successfully adapted for use as an epicardial generator to manage complex cardiac disease, such as congenital heart block, in preterm neonates. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Emma Brackett; Joseph Burns; Natalie K. Craik; Donnchadh O’Sullivan; BriAnna Souder; Shaine A. Morris; Betül Yılmaz Furtun; Tam Doan; Taylor S. Howard; J.S. Heinle; Rocky Tsang; Joseph J. Knadler; Nirica M. Borges

doi:10.32990/apcc.2026.00010

June 30, 2026Archives of Pediatric Critical CareOpen Access

Use of a Leadless pacemaker adapted as a generator for epicardial pacing in a preterm neonate with Sjögren's-syndrome-related antigen A-mediated carditis and congenital heart block

View Full Paper

Ask AI

Bookmark

Share

Key result

Adapted MICRA pacemaker provides stable epicardial pacing in a preterm neonate with severe congenital heart block.

n=1

Why the study?

Maternal autoantibodies from systemic lupus erythematosus and Sjögren's syndrome can cause fetal and neonatal cardiac abnormalities, requiring novel pacing solutions for complex presentations such as CHB and carditis.

Can a leadless pacemaker be adapted as an epicardial generator to manage congenital heart block in a preterm neonate?

Key Points

To describe the novel adaptation and application of a leadless pacing system as an epicardial generator in a preterm neonate with severe SSA-mediated congenital heart block and carditis.
Evaluated a preterm neonate presenting with maternal SSA-mediated congenital heart block, carditis, and profound bradycardia.
Adapted and surgically implanted a Medtronic MICRA implantable pulse generator for epicardial pacing set to pace continuously at 120 bpm.
Epicardial adaptation provided stable long-term rhythm management and marked improvement in myocardial function, supporting growth until conversion to a permanent dual-chamber system.
Continuous pacing at 120 bpm substantially reduced device longevity relative to typical adult pacing where longevity often exceeds 10 years.
Postoperative recovery was complicated by incision site cellulitis alongside prematurity-related respiratory and feeding challenges, with an overall favorable outcome.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

Can a leadless pacemaker be adapted as an epicardial generator to manage congenital heart block in a preterm neonate?

P

Population

A single preterm male neonate born at 33 weeks gestation with severe congenital heart block and carditis secondary to maternal Sjögren's syndrome, followed for nearly 2 years.

I

Intervention

Medtronic MICRA leadless pacing system adapted for use as an epicardial generator

O

Outcome

Management of complex cardiac disease

A leadless pacemaker can be adapted as an epicardial generator for pacing in preterm neonates with congenital heart block.

Limitations

Single case report, limiting generalizability
Reduced device longevity due to continuous high-rate pacing
Required subsequent conversion to a dual-chamber system for atrioventricular synchrony

Implication

Supports feasibility of adapted leadless pacing in neonatal CHB; hypothesis-generating pending comparative data.

Abstract

The transplacental transmission of maternal autoantibodies associated with systemic lupus erythematosus and Sjögren's syndrome can result in a spectrum of cardiac abnormalities in the fetus and neonate, including congenital heart block (CHB), carditis, and cardiomyopathy.This report describes the novel use of the Medtronic MICRA leadless pacing system, adapted for use as an epicardial generator in a neonate with severe fetal Sjögren's-syndrome-related antigen A-mediated disease, including CHB with profound bradycardia and significant carditis.This case highlights the application of a modified Medtronic MICRA implantable pulse generator in the management of complex cardiac disease in a preterm neonate.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Brackett et al. (2026) conducted a case report in Congenital heart block and carditis (n=1). Medtronic MICRA implantable pulse generator adapted for epicardial application was evaluated. The adaptation of a Medtronic MICRA leadless pacemaker for epicardial pacing successfully provided stable rhythm management and supported clinical recovery in a preterm neonate with severe congenital heart block.

synapsesocial.com/papers/6a4601a99ed134303131171f https://doi.org/10.32990/apcc.2026.00010

View Full Paper

Ask AI

Bookmark

Share

Use of a Leadless pacemaker adapted as a generator for epicardial pacing in a preterm neonate with Sjögren's-syndrome-related antigen A-mediated carditis and congenital heart block

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Use of a Leadless pacemaker adapted as a generator for epicardial pacing in a preterm neonate with Sjögren's-syndrome-related antigen A-mediated carditis and congenital heart block

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading