Intravenous pacemaker lead implantation for a pediatric patient: A 16-year follow-up study

Intravenous pacemaker lead implantation for small children is not performed routinely. Here, we report the case of a pediatric patient who underwent endocardial lead implantation and follow-up for 16 years. The patient was a 4-year-old boy who underwent total correction of pulmonary atresia with ventricular septal defect following several palliative operations. After the patient underwent total correction, atrial flutter was noted. Atrial flutter was successfully terminated by overdrive pacing. However, atrial flutter occurred again immediately after overdrive pacing. To treat atrial flutter caused by sick sinus syndrome, a screw-in type lead was attached to the free wall of the right atrium and an excess loop was left to allow for the patient's growth. During the 16-year follow-up, no adverse effects were observed except for a gradual increase in pacing threshold. The selection of a small-sized endocardial lead and an appropriate entry vein, with meticulous management of the leads, makes implantation of an endocardial lead for small children easier and safer.