Paediatric Pacemaker Implantation

A permanent pacemaker is a compact, life-changing device designed to emit electrical signals that initiate or regulate a slow heartbeat. It's particularly beneficial for children whose natural heart pacemaker, the sinoatrial (SA) node is not developed properly or got damaged during any cardiac surgery usually performed to correct birth defects.

In neonates and infants( aged less than 1 years), pacemakers are typically implanted in the abdomen, with the connecting wires placed on the heart's exterior surface. This strategic placement leverages the natural padding of the abdomen, safeguarding the device and wires from potential injuries that can occur during common childhood activities, such as climbing, running and falling. As for children and adolescents, the pacemaker is usually placed under the collarbone in the shoulder area.

Trust in the hands of Dr Karthigesan, a renowned name in paediatric cardiology, for the safe and expert implantation of paediatric pacemakers. His extensive experience and compassionate approach ensure a smooth journey towards a healthier heartbeat for your child. Secure your child's heart health with the best electrophysiologist, Dr. Karthigesan - guiding young hearts towards the rhythm they deserve.

The pacemaker, a crucial piece of technology for heart health, is composed of 2 integral parts: the pacing leads and the pulse generator. The pulse generator is the device's hub, housing both the intricate electronic circuits and the battery that powers it. On the other hand, pacing leads connect the pulse generator with the heart using flexible and insulated wires. These leads are responsible for delivering electronic impulses to the heart. When it comes to children, pacemakers come in three primary types:

• Single chamber pacemakers - These pacemakers feature a single lead. They are simple yet effective, designed for specific heart conditions.
• Dual chamber pacemakers - Equipped with two leads, these devices offer a higher level of synchronisation between the chambers of the heart.
• Biventricular pacemakers - With three leads, these pacemakers provide advanced therapy for more complex heart conditions.

The journey towards pacemaker implantation begins with a comprehensive evaluation of your child's health. Dr Karthigesan initiates the process with a thorough analysis, covering your child's symptoms, their medical history, and your family's medical history. Recommended tests include:

• Echocardiogram (Echo): This test offers a detailed examination of the heart's chambers, walls, and valves, providing a clear view of how effectively the heart pumps blood.
• Holter monitor: This device records your child's heart rhythm during daily activities, offering real-time insight into any anomalies that may occur during regular movement and play.
• External loop recorder: An External/Event Loop Recorder serves as a recording device designed to monitor and record heart rhythms. Worn around the clock, it consistently monitors your child's heart activity, capturing and storing instances of irregular electrical patterns.
• Cardiac event monitor: Essentially a portable EKG machine, this tool is designed to record heart rhythms that occur infrequently, such as those that might only manifest a few times a month.
• Stress test: This test involves an EKG recording of heartbeats during increased activity levels, providing valuable data on how the heart responds to physical stress.

For older children and teenagers receiving a transvenous pacemaker:

• A small prick is made just beneath the collarbone.
• The pacemaker lead(s) are then introduced into the heart through a blood vessel running under the collarbone.
• This procedure is typically performed in a catheterisation laboratory.

For younger children, the process is slightly different:

• The pacemaker is placed into the abdomen via a small keyhole.
• A second keyhole is made in the chest to visualise the heart.
• The lead(s) are guided to the heart and placed on the heart's surface.
• This procedure is executed in an operating room.

The pacemaker implantation procedure generally lasts for two hours. Following the completion of the procedure, the child enters a recovery phase lasting several hours. Typically, children are ready to return home within one to two days after the procedure.