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  lüll Endocardial pacemaker implantation in neonates and infants Ayabakan C; Rosenthal EIndian Pacing Electrophysiol J  2006[Apr]; 6 (2): 57-62Transvenous pacemaker lead implantation is the preferred method of pacing in  adult patients. Lead performance and longevity are superior and the implantation  approach can be performed under local anaesthetic with a very low morbidity. In  children, and especially in neonates and infants, the epicardial route was  traditionally chosen until the advent of smaller generators and lead implantation  techniques that allowed growth of the child without lead displacement.  Endocardial implantation is not universally accepted, however, as there is an  incidence of venous occlusion of the smaller veins of neonates and infants with  concerns for loss of venous access in the future. Growing experience with lower  profile leads, however, reveals that endocardial pacing too can be performed with  low morbidity and good long-term results in neonates and infants.ä |