Abstract
Leadless pacemakers have an accepted role with demonstrable benefits in adults. In contrast, implant experience and follow-up data in pediatric patients are more limited. Clinical indications and patient candidacy for leadless pacing in pediatrics continue to evolve. We present our experience implanting a leadless pacemaker in a four-year-old for the treatment of high-grade atrioventricular block. Implant considerations in small patients, short-term patient and device follow-up data, and follow-up assessment of the vessel used for implantation are discussed.