[Pacemaker implantation in 7 days or less old of early neonates].

We have implanted cardiac pacemaker (PM) in 3 early neonates ranging from 5 hours old to 7 days old of age with congenital complete or incomplete AV block. They were in advanced stage of rapidly developed cardiac failure with resistance to drug therapy and with ventricular tachycardia or fibrillation. Cardiac failure was improved immediately in the 3 cases after the operation and the effectiveness by the pacing was recognized for a long term observation (4 months to 2 years). There appeared PM implantation in-14 neonates, including our cases, in Japanese literatures. In review of the 14 neonates, we discussed the autoimmune disease, indication of the pacing, implantation site of the PM generator and prognosis. An immediate PM implantation after birth in neonate with cardiac failure complicated by congenital AV block is treatment of choice. The generator as well as the electrode design for neonates are still yet to be developed.