Discover how a leadless pacemaker provides a safer solution for a 15-year-old female with congenital complete heart block. Learn about the benefits of this innovative technology at Norton Children’s Heart Institute.
The patient
A 15-year-old female with congenital complete heart block needed a pacemaker battery change or pacemaker update.
Congenital complete heart block leads to interruption of electrical signals between the top chambers of the heart and the bottom chambers of the heart. This often causes clinically significant slow heart rates and eventually requires implantation of a permanent pacemaker.
The patient previously had a pacemaker implanted by cardiac surgeons via open-heart surgery. The pacemaker battery (generator) was placed in her abdomen — standard practice in those too young for an adult size pacemaker to be placed on top of or below the pectoralis muscle.
After many years with this pacing system, her battery was depleting, and it was time for a pacemaker battery change. Now that she was older, we considered moving the pacemaker to a more standard location on top of or below the pectoralis muscle with pacing leads placed inside the heart through a vein.
The challenge
The patient is a competitive volleyball player. In cases where the pacemaker is placed in the abdomen or over/below the pectoralis muscle, there is a chance of direct trauma or damage to the pacemaker during contact sports. This may be life-threatening in some cases and require urgent surgery. Additionally, this often imposes some restrictions on competitive athletes playing contact sports.
The physicians
Pediatric electrophysiologist and pediatric cardiologist
Norton Children’s Heart Institute, affiliated with the UofL School of Medicine
Christopher L. Johnsrude, M.D.
Pediatric electrophysiologist and pediatric cardiologist
Norton Children’s Heart Institute, affiliated with the UofL School of Medicine
Refer a patient
To refer a patient to Norton Leatherman Spine, visit Norton EpicLink and open an order for Spine Surgery.
The solution
A leadless pacemaker, now commercially available, was placed via a leg vein in the right ventricle. The pacemaker is 93% smaller than conventional pacemakers and about the size of a large vitamin capsule.
With the system situated completely inside the right ventricle, the leadless pacemaker does not have the same risk of being damaged during contact sports.
No specific sports restrictions apply in these cases and the post-operative recovery period in such cases is significantly shorter.
The result
The procedure was performed successfully without any complications. The pacemaker is functioning appropriately, and the patient is currently active in volleyball with no untoward side effects or exercise limitations.
