Age-related role of ambulatory electrocardiographic monitoring in risk stratification of patients with complete congenital atrioventricular block

Vukomanović, Vladislav; Stajevic, Mila; Košutić, Jovan; Stojanov, Petar; Rakic, Sanja; Velinović, Miloš; Sehic, Igor; Milovanović, Vladimir

doi:10.1093/europace/eul174

Cited by 7 publications

(9 citation statements)

References 23 publications

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“…При обследо-вании 45 детей 1-17 лет с врожденной полной АВ блокадой V Vukomanovic и соавт. [510] выделили пре-дикторы приступов Морганьи-Адамса-Стокса (МАС) и сердечной недостаточности в различных возраст-ных группах. У новорожденных детей с сердечной недостаточностью на фоне полной АВ блокады были выявлены достоверные различия в значениях макси-…”

Section: хм у детей с кардиоваскулярной патологиейunclassified

National Russian Guidelines on Application of the Methods of Holter Monitoring in Clinical Practice

Макаров¹,

Комолятова²,

Куприянова³

et al. 2014

Russ J Cardiol

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Section: хм у детей с кардиоваскулярной патологиейunclassified

National Russian Guidelines on Application of the Methods of Holter Monitoring in Clinical Practice

Макаров¹,

Комолятова²,

Куприянова³

et al. 2014

Russ J Cardiol

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“…5 Adams-Stokes attacks and heart failure may develop at any age in children with CCAVB. 15 Patients with CCAVB can appear healthy, especially when they have no other cardiovascular problems, but it is clearly established that the first manifestation of CCAVB can be sudden death.…”

Section: Etiology and Risk Factorsmentioning

confidence: 99%

“…3 Also, heart rate decreases progressively in adults with CCAVB as they become older, a change that does not occur in healthy adults. 15 A physiological explanation for increased signs and symptoms of decompensation in older patients with CAVB is related to the deterioration of physiological compensatory mechanisms. 6 Signs and symptoms in CCAVB are due to a slow heart rate with resultant low cardiac output.…”

Section: Clinical Featuresmentioning

confidence: 99%

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Congenital Complete Atrioventricular Block in a Young Man: A Case Study

Chronister

2009

Critical Care Nurse

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“…Earlier investigations on third-degree AVB have focused on minimum, maximum, and average daily heart rates to identify patients at higher risk for sudden death and determine indications for permanent pacing, with no details regarding heart rate variability (21,22). In a recent report evaluating 24-h Holters in patients with congenital third-degree AVB, Vukomanovic et al (21) showed that low maximum and average daytime heart rates were important risk factors for Adams-Stokes attacks and heart failure. Junctional ectopic tachycardia and significant ventricular ectopy were not documented.…”

Section: See Page 77mentioning

confidence: 99%

New Insights Into Fetal Atrioventricular Block Using Fetal Magnetocardiography⁎⁎Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.

Hornberger

Collins

2008

Journal of the American College of Cardiology

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Routine fetal arrhythmia assessment typically involves the use of echocardiographic modalities that demonstrate mechanical events from which electrophysiological events are inferred (1). While M-mode and Doppler-based techniques have been used successfully to diagnose third-degree atrioventricular block (AVB), second-degree AVB, and, more recently, first-degree AVB, our evaluation has been limited to atrial and ventricular rates (2-4), gross P-R interval estimates using atrial-ventricular activity time intervals (5), and rarely detected ventricular ectopy. Although fetal electrocardiogram (ECG) has been shown to be more sensitive than echocardiogram-based techniques in detecting firstdegree AVB in anti-Ro-positive pregnancies (6), it has limited use in the evaluation of fetal heart rates out of the normal range, is more difficult to acquire at 28 to 32 weeks, and involves signal averaging, all limiting its clinical application. See page 77Fetal magnetocardiography, the magnetic analog of fetal ECG, is at this time the most effective means of assessing fetal rhythms. Through the work of Zhao et al. (7), it has provided new insight into the electrophysiological characteristics of fetal AVB. Their observations suggest fetal AVB with and without structural heart disease is far more complex than previously appreciated with complex changing rhythms and variable atrioventricular conduction in seconddegree AVB, and abnormal QRS waveforms, co-existence of junctional and ventricular ectopy, and atrial and ventricular rate responsivity in third-degree AVB. Fetal magnetocardiography, however, requires a magnetically shielded facility and is available in very few centers. Furthermore, Zhao et al. (7) studied patients for 50 to 100 min at a time, longer duration than is typical of fetal echocardiography. Still, these new observations should prompt a search for perhaps more practical tools to evaluate electrophysiological events in fetal AVB that will ultimately improve the care of affected pregnancies.In normal pregnancies, fetal heart rate variability and accelerations associated with fetal activity increase with gestation (8,9) coinciding with maturation of the autonomic nervous system. In contrast, reduced fetal heart rate variability and accelerations particularly within lower heart rate ranges (10,11) occur in intrauterine growth restriction and chronic fetal hypoxemia. This has been used clinically to identify the fetus at greatest risk for sudden demise as a consequence of an inability to acutely adapt to changing physiological conditions. That many fetuses with isolated AVB have atrial and ventricular beat-to-beat variability and responsivity (7) suggests similar autonomic control exists, at least at higher ventricular rates. A ventricular rate of Ͻ56

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Age-related role of ambulatory electrocardiographic monitoring in risk stratification of patients with complete congenital atrioventricular block

Cited by 7 publications

References 23 publications

National Russian Guidelines on Application of the Methods of Holter Monitoring in Clinical Practice

National Russian Guidelines on Application of the Methods of Holter Monitoring in Clinical Practice

Congenital Complete Atrioventricular Block in a Young Man: A Case Study

New Insights Into Fetal Atrioventricular Block Using Fetal Magnetocardiography⁎⁎Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.

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