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Pacemakers, relied upon by many patients with irregular heart rhythms, are not built for children. Scrambling up trees, hanging from monkey bars, and even the simple act of growing make the device more likely to fail. 

Roughly 1 in 15,000 children are born with congenital heart block, which causes an abnormally slow heart rate. The condition leads to lightheadedness, shortness of breath, and in serious cases, heart failure. Medications work in the short-term, but for children with more severe symptoms, pacemakers are the most reliable, durable treatment — though one fraught with risks. Traditional pacemakers have wires, or leads, that send electrical pulses to a slow-beating heart. The leads, however, do not mesh well with a growing body.  

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“The amount of physical activity that children do far exceeds a 60- or 70-year-old,” said Maully Shah, director of cardiac electrophysiology at the Children’s Hospital of Philadelphia. More than 70% of people with pacemakers are at least 65 years old. “None of these leads are really tested when they’re manufactured to accommodate for growth.” 

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