scholarly journals Pacing Therapy in Infants and Children with Congenital and Acquired Complete Atrioventricular Block: Optimal Pacing Strategies, Management, and Follow-up

Author(s):  
Floris E.A. Udink ten Cate ◽  
Narayanswami Sreeram
2017 ◽  
Vol 45 (5) ◽  
pp. 1597-1601 ◽  
Author(s):  
Zhenyu Jiao ◽  
Ying Tian ◽  
Xinchun Yang ◽  
Xingpeng Liu

A 59-year-old male patient was admitted with the main complaints of stuffiness and shortness of breath. An ECG from precordial leads on admission showed masquerading bundle branch block. Syncope frequently occurred after admission. During syncope episodes, ECG telemetry showed that the syncope was caused by intermittent complete atrioventricular block, with the longest RR interval lasting for 4.36 s. At the gap of syncope, ECG showed complete right bundle branch block accompanied by alternation of left anterior fascicular block and left posterior fascicular block. The patient was implanted with a dual-chamber permanent pacemaker. Follow-up of 9 months showed no reoccurrence of syncope.


2007 ◽  
Vol 30 (11) ◽  
pp. 1339-1343 ◽  
Author(s):  
GERTIE C.M. BEAUFORT-KROL ◽  
MIEK J.M. SCHASFOORT-VAN LEEUWEN ◽  
YMKJE STIENSTRA ◽  
MARGREET Th.E. BINK-BOELKENS

1992 ◽  
Vol 3 (1) ◽  
pp. 255-267
Author(s):  
Debra G. Hanisch ◽  
Linda Perron

Dysrhythmias in infants and children are, in many ways, similar to those in adults, yet several important differences exist in their presentation and management. Complex dysrhythmias most frequently encountered in pediatrics include sinus node dysfunction, chaotic atrial rhythm, atrial flutter, supraventricular tachycardia (including Wolff-Parkinson-White syndrome and junctional ectopic tachycardia), complete atrioventricular block (congenital and acquired), and ventricular dysrhythmias (premature ventricular contractions and ventricular tachycardia). Newer approaches to the diagnosis and management of these dysrhythmias are addressed in this paper


2017 ◽  
Vol 7 (3) ◽  
pp. 218-223 ◽  
Author(s):  
Silvia Aguiar Rosa ◽  
Ana Teresa Timóteo ◽  
Lurdes Ferreira ◽  
Ramiro Carvalho ◽  
Mario Oliveira ◽  
...  

Purpose: The aim was to characterise acute coronary syndrome patients with complete atrioventricular block and to assess the effect on outcome. Methods: Patients admitted with acute coronary syndrome were divided according to the presence of complete atrioventricular block: group 1, with complete atrioventricular block; group 2, without complete atrioventricular block. Clinical, electrocardiographic and echocardiographic characteristics and prognosis during one year follow-up were compared between the groups. Results: Among 4799 acute coronary syndrome patients admitted during the study period, 91 (1.9%) presented with complete atrioventricular block. At presentation, group 1 patients presented with lower systolic blood pressure, higher Killip class and incidence of syncope. In group 1, 86.8% presented with ST-segment elevation myocardial infarction (STEMI), and inferior STEMI was verified in 79.1% of patients in group 1 compared with 21.9% in group 2 ( P<0.001). Right ventricular myocardial infarction was more frequent in group 1 (3.3% vs. 0.2%; P<0.001). Among patients who underwent fibrinolysis complete atrioventricular block was observed in 7.3% in contrast to 2.5% in patients submitted to primary percutaneous coronary intervention ( P<0.001). During hospitalisation group 1 had worse outcomes, with a higher incidence of cardiogenic shock (33.0% vs. 4.5%; P<0.001), ventricular arrhythmias (17.6% vs. 3.6%; P<0.001) and the need for invasive mechanical ventilation (25.3% vs. 5.1%; P<0.001). After a propensity score analysis, in a multivariate regression model, complete atrioventricular block was an independent predictor of hospital mortality (odds ratio 3.671; P=0.045). There was no significant difference in mortality at one-year follow-up between the study groups. Conclusion: Complete atrioventricular block conferred a worse outcome during hospitalisation, including a higher incidence of cardiogenic shock, ventricular arrhythmias and death.


2009 ◽  
Vol 32 (7) ◽  
pp. 952-956 ◽  
Author(s):  
FRÉDÉRIC SACHER ◽  
HERVÉ DOUARD ◽  
MATTHEW WRIGHT ◽  
BERNARD VIRCOULON ◽  
JEAN-PAUL BROUSTET

1996 ◽  
Vol 6 (4) ◽  
pp. 315-319 ◽  
Author(s):  
Elizabeth Villain ◽  
Damien Bonnet ◽  
Conceicão Trigo ◽  
Laurence Iserin ◽  
Daniel Sidi ◽  
...  

AbstractSecond degree atrioventricular block is uncommon in children. In order to evaluate its outcome, and to find early prognostic factors, we reviewed the history and evolution of 21 children with this arrhythmia discovered on their surface electrocardiogram. Twenty-four-hour monitoring displayed variations in the conduction patterns in almost all children, from long PR interval to complete heart block alternating in the same patient. At follow-up (nine months to 19 years), 13 children (62%) had received implantation of a pacemaker because of progression either to complete atrioventricular block or to severe ventricular bradycardia. Atrioventricular conduction improved on exercise in 11 children, but this did not predict a favorable outcome since four of them required pacing. In contrast, deterioration during sinus acceleration in four patients predicted further aggravation. A supra-Hisian location of the block did not protect against the occurrence of syncope in the two patients who underwent His recordings. Finally, the outcome was not linked to age at diagnosis. Second degree atrioventricular block, therefore, should be considered a serious disease because of its trend to worsen towards complete block and/or severe complications. Close follow-up, including repeated 24-hour monitoring, is the most effective way to unmask such a progression and to avoid its clinical consequences.


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