Beating Strong: A Lifechanging Pacemaker Procedure for Maeve

At her routine 20-week ultrasound at Northwestern Medicine, Nicole learned her unborn baby had a heart rate of just 50 bpm, well below the normal 160 bpm for that stage of pregnancy. Nicole was immediately referred to a fetal cardiology appointment the next day at The Chicago Institute for Fetal Health at Lurie Children’s. The fetal cardiology team confirmed her unborn baby had complete heart block, a disorder causing low heart rates.  
The prenatal heart block diagnosis required close monitoring throughout the pregnancy to ensure an adequate heart rate for growth and development. Newborns with complete heart block may need emergency interventions soon after birth including pacing the heart at a faster heart rate. In many cases doctors use a pacemaker, a device that sends electrical impulses to the heart to tell it to beat faster. Electrophysiologists at Lurie Children’s diagnose and treat rhythm problems such as heart block sometimes even before birth. The Electrophysiology Program at Lurie Children’s is the largest pediatric electrophysiology program in Illinois and treats one of the vastest clinical volumes nationally.

Identifying the arrhythmia before birth allowed the medical specialists at Lurie Children’s to make plans to treat the baby after birth. Nicole and her husband Sean met weekly and sometimes biweekly with a team of surgeons, physicians and nurses to plan for their baby’s arrival.

Nicole and Sean were nervous but said, “there was never a sliver of doubt about how our team was handling our case.”

When Maeve was born, a team of specialists assembled, ready to put the care plan into action. “Maeve needed a pacemaker quickly, however pacemakers are designed for adults and implanting a device that large in a five-pound baby such as Maeve, carries significant risk”, said Dr. Sami Chaouki, an electrophysiologist working with Nicole and Sean since before delivery.

Maeve’s team determined that she would be best served by a novel system using an adult pacemaker designed to be implanted directly in the heart, the Medtronic Micra, connected to a standard pacing lead connected to the heart. There was just one obstacle: this system is not FDA approved. Maeve’s medical team was persistent in completing the necessary paperwork and working with the Food and Drug Administration (FDA) to quickly get the pacemaker approved for emergency use for Maeve. 

At just eight days old Maeve underwent a procedure to receive her pacemaker. Due to her team’s careful precision placing the device and wires, the pacemaker is expected to last longer than average, and Maeve may not need to receive a new pacemaker for several years. 

“This is the first Micra pacemaker I had placed, and Maeve was the smallest patient I had placed a pacemaker in,” said Dr. Allison Davila, cardiovascular-thoracic surgeon at Lurie Children’s. “We were very thoughtful about where to place both the generator and the leads, to have the best outcome for her after surgery.  I’m grateful for the hard work from the medical team to secure this device for our smallest patients, and that for Maeve, it may last her well into her elementary school years.” 

Now, at eight months old, Maeve is keeping up with her specialists at outpatient visits throughout the Chicago area. Maeve is living her best life and discovering everything the world has to offer. Her parents have taken her to meet new friends and are proud of her resilience and quick recovery. 

Read more about the Heart Center at Lurie Children’s.