Epicardial pacemaker extrusion in a pediatric patient with congenital heart disease: A rare complication

Epicardial pacemaker implantation is a standard approach for managing complete atrioventricular block in pediatric patients following congenital heart surgery. Although complications related to epicardial pacing are relatively common, pacemaker extrusion remains a rare and potentially serious event, particularly in children with Down syndrome. We report the case of a 15-month-old boy with Down syndrome who developed epicardial pacemaker extrusion six months after initial implantation. After infection control with intravenous antibiotics, the pacemaker system was surgically explanted and successfully re-implanted without postoperative complications. This case underscores the importance of vigilant follow-up and timely surgical management to prevent adverse outcomes in similar high-risk patients.