Use of a Leadless pacemaker adapted as a generator for epicardial pacing in a preterm neonate with Sjögren's-syndrome-related antigen A-mediated carditis and congenital heart block

The transplacental transmission of maternal autoantibodies associated with systemic lupus erythematosus and Sjögren's syndrome can result in a spectrum of cardiac abnormalities in the fetus and neonate, including congenital heart block (CHB), carditis, and cardiomyopathy.This report describes the novel use of the Medtronic MICRA leadless pacing system, adapted for use as an epicardial generator in a neonate with severe fetal Sjögren's-syndrome-related antigen A-mediated disease, including CHB with profound bradycardia and significant carditis.This case highlights the application of a modified Medtronic MICRA implantable pulse generator in the management of complex cardiac disease in a preterm neonate.