Migration of an Epicardial Pacemaker to the Pericardial Space in an Infant

We report the case of a 4‐month‐old infant who was implanted with an epicardial ventricular pacing system at 6 days of age for the prolonged QT syndrome, who subsequently developed migration of the pulse generator to the pericardial space. Tracking of the pulse generator through the diaphragm and into the pericardium followed the route of the myocardial lead. The possibility of pulse generator migration, as well as disruption of the diaphragm and pericardium, should be considered by those who care for infants with implanted pacemakers.