Guidelines for the implantation of cardiac implantable electronic devices (CIEDs) have evolved since publication of the initial ACC/AHA pacemaker guidelines in 1984 [1]. CIEDs have evolved to include novel forms of cardiac pacing, the development of implantable cardioverter defibrillators (ICDs) and the introduction of devices for long term monitoring of heart rhythm and other physiologic parameters. In view of the increasing complexity of both devices and patients, practice guidelines, by necessity, have become increasingly specific. In 2018, the ACC/AHA/HRS published Guidelines on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay [2], which were specific recommendations for patients >18 years of age. This age-specific threshold was established in view of the differing indications for CIEDs in young patients as well as size-specific technology factors. Therefore, the following document was developed to update and further delineate indications for the use and management of CIEDs in pediatric patients, defined as ≤21 years of age, with recognition that there is often overlap in the care of patents between 18 and 21 years of age. This document is an abbreviated expert consensus statement (ECS) intended to focus primarily on the indications for CIEDs in the setting of specific disease/diagnostic categories. This document will also provide guidance regarding the management of lead systems and follow-up evaluation for pediatric patients with CIEDs. The recommendations are presented in an abbreviated modular format, with each section including the complete table of recommendations along with a brief synopsis of supportive text and select references to provide some context for the recommendations. This document is not intended to provide an exhaustive discussion of the basis for each of the recommendations, which are further addressed in the comprehensive PACES-CIED document [3], with further data easily accessible in electronic searches or textbooks.

Advocate Children's Heart Institute Chicago IL USA

Amrita Institute of Medical Sciences Kochi India

Bambino Gesù Children's Hospital IRCCS Rome Italy

Baylor College of Medicine Houston TX USA

Bristol Royal Hospital for Children Bristol UK

Children's Heart Center Charles University Prague and Motol University Hospital Prague Czech Republic

Evelina London Children's Hospital and St Thomas' Hospital Guy's and St Thomas' NHS Foundation Trust London UK

Georg August University Medical Center Göttingen Germany

George Washington University Washington DC USA

Harvard Medical School Boston Massachussetts USA

Heart Centre Leipzig University of Leipzig Leipzig Germany

Hospital de Pediatría Juan P Garrahan Hospital El Cruce Hospital Británico de Buenos Aires Instituto Cardiovascular ICBA Buenos Aires Argentina

Inova Children's Hospital Fairfax VA USA

Mayo Clinic Rochester MN USA

New York Univeristy Grossman School of Medicine New York NY USA

New York University Langone Health New York NY USA

Nicklaus Children's Hospital Miami FL USA

Oregon Health and Science University Portland OR USA

Shizuoka General Hospital and Mt Fuji Shizuoka Children's Hospital Shizuoka Japan

St Luke's Health System Boise ID USA

Stanford University Palo Alto California USA

The Hospital for Sick Children Toronto Canada

University of Michigan Ann Arbor MI USA

University of Missouri Kansas City School of Medicine Kansas City MO USA

University of Pennsylvania Perelman School of Medicine Philadelphia PA USA

University of Southern California Keck School of Medicine Los Angeles California USA

University of Utah Health Sciences Center Salt Lake City UT USA

University of Wisconsin School of Medicine and Public Health Madison WI USA

University Pediatricians Children's Hospital of Michigan Detroit MI USA

Vanderbilt University Medical Center Nashville TN USA

Washington University in St Louis St Louis Missouri USA

Yale University School of Medicine New Haven CT USA

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