Pacemaker dislocation--truly ectopic activation necessitating surgical treatment.

Intra-abdominal migration of a generator from an epicardial pacemaker system is a rare but potentially life-threatening complication. We report on a case of a 2-year-old child in whom the generator silently migrated from the sheath of the rectus abdominis muscle in the upper abdominal wall down into the peritoneal cavity. We advise that if there is any evidence of intra-abdominal migration, the generator should be properly repositioned without delay.