Efficacy of closed-loop stimulation with epicardial leads in an infant with congenital atrioventricular block.

We present the case of an infant with a congenital atrioventricular block and sinus node dysfunction that was implanted with a pacemaker with physiological closed-loop stimulation (DDD-CLS) pacing mode with two epicardial leads. We have observed the response of DDD-CLS system with respect to conventional rate responsive accelerometer-based mode (DDDR): the atrial pacing percentage and the 24 h rate trend showed higher values during DDD-CLS compared with DDDR. In this patient, rate responsive feature seems preserved in DDD-CLS also using epicardial leads.