A newborn baby weighing just 2.1 kilograms is living a normal life at home today thanks to a pioneering procedure at Barcelona’s SJD Barcelona Children’s Hospital, where surgeons implanted the world’s smallest pacemaker to correct a life-threatening heart condition.
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The team specially adapted the tiny device, measuring only two centimetres, for the infant after doctors detected a severe cardiac abnormality during the second trimester of pregnancy. This case highlights a remarkable collaboration between medical and engineering experts to create a bespoke solution where none previously existed.
A Critical In Utero Diagnosis
During a routine check-up, specialists at the hospital in Esplugues de Llobregat identified a complete atrioventricular block in the foetus. This serious condition prevents electrical impulses from passing correctly between the heart’s chambers, causing a dangerously slow heartbeat known as bradycardia.
As a result, the heart struggles to pump enough oxygenated blood to the body and brain. To compensate, the organ begins to dilate and enlarge, a symptom doctors observed in the foetus. The medical team initiated close monitoring of the pregnancy. However, by late January, the baby’s condition worsened, prompting the decision to induce an early delivery.
The baby girl was born on 2 February with severe bradycardia and was at immediate risk of cardiac failure. According to a hospital statement reported by Europa Press, the medical team implanted a temporary pacemaker in the first few hours of her life to stabilise her condition while preparing for a permanent solution.
Engineering a Life-Saving Solution
Conventional pacemakers measure around six centimetres, a size far too large for a newborn’s chest cavity, where it could cause organ compression and a high risk of infection. Faced with this challenge, the Sant Joan de Déu team worked with the medical device company Abbott to adapt its AVEIR pacemaker platform for an infant.
The result was a two-centimetre synchronised pacemaker, the smallest of its kind in the world. Since the device was specially adapted for this case, the hospital sought urgent authorisation from the Spanish Agency for Medicines and Health Products (AEMPS). The agency responded with remarkable speed, granting approval in just five hours. This allowed the team to proceed without delay.
Just hours after the baby’s birth, a 16-person multidisciplinary team of paediatric cardiologists, cardiac surgeons, anaesthetists, and neonatologists, led by head of cardiac surgery Stefano Congiu, performed the definitive implantation.
“The device allows us to stimulate and coordinate the heartbeat appropriately, which is fundamental in an organ so small and previously dilated,” explained Dr. Georgia Sarquella-Brugada, Head of the Pediatric Cardiology Service at the hospital.
The Power of Collaboration
Dr. Sarquella-Brugada stressed that standard solutions often do not exist in paediatric cardiology. “When we talk about a two-kilo baby, we have to adapt the technology to their size and physiology,” she said. “This case demonstrates that collaboration between doctors and engineers can mark the difference between having no options and being able to save a life.”
The hospital also praised the project as a clear example of corporate social responsibility. It noted that given the small number of potential patients, the mini-pacemaker has very limited commercial viability, as reported by La Vanguardia. The success of this procedure offers hope for the handful of babies born each year in Spain with severe congenital heart blocks requiring immediate intervention.
This breakthrough is another example of Barcelona’s world-class medical institutions pushing the boundaries of patient care. It follows other recent successes in the city, such as a new protocol at Hospital Del Mar that has cut intestinal infarction deaths by 80%.
Following the procedure, the baby girl’s progress was excellent. After a 20-day hospital stay, doctors discharged her. She is now expected to lead a normal life, with only periodic check-ups required at the hospital.
