Permanent pacemakers were implanted in 12 children, ages 2 weeks to 6 years. The cause of the arrhythmia was congenital in three, postoperative in six, viral in one, and unknown in two. One operative death occurred on the second postoperative day. Two late deaths occurred five and 10½ years postoperatively. The late deaths were in patients with good cardiac capture in whom the block followed repair of tetralogy of Fallot. Ventricular arrhythmias were believed to be the cause of death.
Reoperation was required 37 times: for pacemaker exhaustion, 17; electrode problems, 15; wound problems, four; and arrhythmia, one. Nine of 12 patients are alive nine months to ten years eight months postoperatively. The remaining three survived for eight to ten years. Frequent reoperation and diligent correction of defective pacing is rewarded with long, active lives in children requiring implantable pacemakers.