Pediatric Pacemaker Placement

Doctors at Children’s Health have implanted more pediatric pacemakers than almost any other hospital in the region. This gives us the expertise to know which pacemaker is right for your child, and to implant it in a way that will help them lead a full, active life.

What is a Pediatric Pacemaker Placement?

Electric pulses in our heart tell it when and how to beat. Sometimes, children have or develop problems that make their hearts beat irregularly. Often, these children need a pacemaker. Pacemakers use electricity to prompt the heart to beat, helping to regulate the heart’s rhythm. Surgeons carefully place these tiny devices in the body and connect them to the heart.

Pediatric pacemaker placement requires a procedure that lasts one to two hours. During the pacemaker procedure, surgeons connect a pacemaker to your child’s heart through two lines called “leads.” Leads carry the pacemaker’s gentle electric signal to the heart to tell it to beat.

Doctors feed one lead through to the upper right chamber of the heart. They feed the other one to the lower right chamber of your child’s heart.

In infants and smaller children, surgeons will place the pacemaker in the abdomen. In older children, doctors will place the pacemaker in the child’s chest. Then, the surgeons will hook the leads into the pacemaker. The surgeons finish by closing the incision.

Adults need pacemakers more often than children. At Children's Health℠, pediatric cardiologists work with cardiologists who place pacemakers in adults. This teamwork helps our pediatric specialists develop the most cutting-edge technology for pacemakers in children.

What are the benefits of a Pediatric Pacemaker Placement?

A pacemaker can save your child’s life by keeping their heart beating in the right rhythm. It can also make their lives fuller and more active. With some precautions, they can play non-contact sports, ride roller coasters and learn to drive safely.

What are the side effects of a Pediatric Pacemaker Placement?

Repeated activities, like raising an arm over and over again, can strain the leads in your child’s pacemaker. Kids need to be mindful of their leads while swimming or playing racquet sports, for example.

At Children’s Health, our team will work with you and your child to identify the best side of their body for placing the pacemaker. That way, your child’s dominant arm and hand are not affected by it, lowering pacemaker risks.

Additionally, the vessels surrounding the leads build scar tissue over time. This can damage the leads. But most pediatric pacemakers last 10 to 20 years before needing repair. They also run on batteries that doctors need to replace every seven to 10 years.

What are the risks of a Pediatric Pacemaker Placement?

During the procedure, surgeons use live, moving X-rays to see where to place the leads in your child’s heart. As with all procedures, there is a very small chance of bleeding or infection. There is also a tiny chance that your child’s heart or lung is injured. These events are rare and all of them can be treated.

At Children’s Health, our experience implanting pacemakers in children of all ages gives us the expertise to keep pacemaker risks and side effects to an absolute minimum.

What to expect with a Pediatric Pacemaker Placement

What to expect before a Pediatric Pacemaker Placement

Before the procedure, the care team will explain your child’s anesthesia. A pacemaker nurse specialist will also show your child models of the leads and pacemaker. Your child can hold and play with these models to become familiar with the pacemaker.

Then, your child’s care team will talk to you about physical restrictions and follow-up appointments.

Pacemakers send data to Children’s Health about your child’s heart health. Your child’s care team will explain to you how to transmit this critical data from home.

What to expect during a Pediatric Pacemaker Placement

Placing a pacemaker takes between one to two hours. The length of the procedure depends on what kind of pacemaker your child gets. Your child will be asleep for the surgery.

You can attend surgery preparation with your child. However, parents must wait outside the operating room during the surgery.

What to expect after a Pediatric Pacemaker Placement

Immediately after the procedure, the care team will take your child to recovery to wake up from anesthesia. Meanwhile, you will meet with the surgeon to go over next steps and ask questions.

Your child will stay overnight at the hospital. The following day, Child Life specialists and pacemaker nurse specialists, will meet about your child and go over your child’s X-ray, EKG and device check. These tests help make sure the device is working correctly.

If the tests go smoothly, your child will spend one last night at the hospital. You can take them home the next day.

Your child will need to take antibiotics in the days after the procedure. Their care team will also prescribe pain medications.

Your child will have a follow-up:

  • Two weeks after the procedure to check the device and healing at the site of surgery
  • Six weeks after that, your child’s care team will want to do another checkup
  • Eight weeks after the procedure, your child should feel recovered

Your child can sleep at night with a sling to remind them not to fling their arms above the shoulder. The pacemaker performs a self-check every day, sometimes early in the morning. Every three months, it will send data to your child’s care team. After those initial check-ups, your child’s care team will need to check the device in person one to two times a year.

How do I prepare my child for a Pediatric Pacemaker Placement?

What is my child allowed to eat and drink before a Pediatric Pacemaker Placement?

Since the placement requires your child to go under general anesthesia, your child should avoid food and drinks for six to eight hours beforehand.

What are the prep instructions for a Pediatric Pacemaker Placement?

Other than avoiding eating and drinking beforehand, there isn’t much physical preparation required for the procedure. However, your child may have questions about having a pacemaker inside their body. They may also be anxious or fearful of the procedure or the pacemaker itself.

Before surgery, your child may need emotional support. At Children’s Health, your child’s care team is here to help provide comfort.

What are the Child Life services for a Pediatric Pacemaker Placement?

Child Life specialists will help your child with post-procedure pain and anxiety. They use devices, such as iPads, to redirect your child and keep them entertained. Child Life specialists also help your child manage fear about things like IVs and anesthesia.

Sometimes, children with pacemakers can feel them working, which can be scary. Some children also develop body-image-related stress around the scarring from the procedure. Ongoing emotional support will be vital, and the Child Life Department is here to help start the journey off on the right foot.

What questions should I ask my provider about a Pediatric Pacemaker Placement?

  • How many pediatric pacemaker placements have you performed?
  • Are there other treatment options for my child, or is this the best one?
  • What medications should my child stop taking before the procedure?
  • How soon will I be able to see my child after the procedure?
  • How can I help my child have as typical of a life as possible?
  • How can we work with my child to help them safely continue doing their favorite activities?
  • Are there activities my child can no longer do?

Frequently Asked Questions

  • Can my child use their iPad and other devices with a pacemaker?

    Yes. However, children with pacemakers should avoid falling asleep with any devices on their chest. Also, the iPhone 12 has a strong enough magnet to offset your child’s pacemaker. Children should keep iPhone 12s either one foot or an arm’s length away, whichever is greater, from their chest at all times.

  • Can my child play contact sports?

    No. However, with some precautions, your child can play any non-contact sport.