13 month old child, generally doing ok, tested at 7 months of age for III degree housing conduction block, heart rate around 44 beats/min during sleep and 70 beats/min during wakefulness. Question 1: Is there any possibility of recovery? A: It has been 6 months since the history was found, the possibility of recovery is extremely slim, medication is no longer relevant, and the main question is when to implant a pacemaker. Question 2: Do I need a pacemaker? A pacemaker should be actively implanted to protect cardiac function and facilitate normal growth and development of the child in cases of III degree housing block. It is too late to consider pacemaker implantation if the heart begins to enlarge on cardiac ultrasound or if the child has symptoms such as fatigue or fainting. Question 3: Is pacemaker implantation appropriate at a young age? The need for a pacemaker has nothing to do with a child’s age. The risks of surgery are much less than the effects of a slow heart rate on a child. As a child grows older, the burden on the heart caused by a slow heart rate increases, and the heart is overloaded for many years, which can cause damage to the heart that is not visible on the surface. Question 4: How much does a pacemaker cost? The cost depends on the type of pacemaker that is implanted, and the life expectancy of the pacemaker for the child is also uncertain. Q5: Once a pacemaker is fitted is there a lifelong dependence on the pacemaker? A: It is often a misconception among parents that they are not dependent on a pacemaker for life because it is implanted, but rather because of their child’s condition. It is important to have regular cardiac ultrasounds before and after the implantation to check for changes in the size of the heart.