DALLAS, April 11, 2023 — Wireless or leadless pacemakers, commonly implanted in adults, may be a safe and effective short-term option for children with slow heartbeats, according to new research published today in Circulation: Arrhythmia and Electrophysiology, a peer-reviewed journal of the American Heart Association.

Children with a heartbeat that is too slow (bradycardia) require pacemakers — devices surgically implanted under the skin of the chest that transmit electrical impulses to regulate the heartbeat. Standard pacemakers use tiny wires, or leads, that are connected to the heart to deliver the lifesaving pacing (electrical signals to keep the heart beating normally). Active, growing children, however, are at higher risk for wire fractures and pacemaker complications because the wires in typical pacemakers may break or malfunction, according to researchers.

The leadless pacemaker is a miniature device, the size of a AAA battery, and it is self-contained and placed directly inside the patient’s heart. It does not require tiny wires (leads) to help regulate the heartbeat.

This study provides the first data on leadless pacemakers in a pediatric population in a real-world setting.

“The leadless pacemaker works very well in children, just like it does in adults. We found it may be safely implanted in select pediatric patients that need pacing,” said lead study author Maully J. Shah, M.B.B.S., director of cardiac electrophysiology in the Cardiac Center at Children’s Hospital of Philadelphia and a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania, both in Philadelphia. “Our study’s results indicate select children may be considered candidates since they may benefit greatly from leadless pacing. However, because of the current technology, which uses a very large catheter designed for adults to place the leadless pacemaker and lack of reliable future extractability of the pacemaker, the wider pediatric population is not able to benefit from this device.”

The Pediatric and Congenital Electrophysiology Society (PACES) maintains a registry of pacemaker implantations performed at 15 centers across the U.S., U.K. and Italy. During the study period (2016-2021), cardiac electrophysiologists implanted the leadless device in carefully selected patients who were experiencing a slow heartbeat. Researchers evaluated data in the registry for one brand of leadless pacemakers to analyze how well the leadless pacemaker performed in 63 children, ages 4 to 21 years (average age 15). For 77% of these children, this was their first pacemaker.

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