Causes of Heart Block in Young and Middle-Aged South Africans

Mkoko, Philasande; Rajoo, Shaune Tamzon; Chin, Ashley

doi:10.1016/j.cpcardiol.2022.101247

Cited by 4 publications

(12 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study determined the etiology of heart block in patients ≤55 years old who were treated with transvenous pacemakers in South Africa. 11 Third-degree AVB was diagnosed in 73.5%, 2:1 AVB in 8.1%, and Mobitz I second-degree AVB in 5.9%. The etiology of AVB could be determined in 97 of 136 patients (71.3%).…”

Section: Epidemiology Of Arrhythmias In Lmicsmentioning

confidence: 96%

Electrophysiology practice in low- and middle-income countries: An updated review on access to care and health delivery

2023

View full text Add to dashboard Cite

Section: Epidemiology Of Arrhythmias In Lmicsmentioning

confidence: 96%

Electrophysiology practice in low- and middle-income countries: An updated review on access to care and health delivery

2023

View full text Add to dashboard Cite

“…Atrioventricular blocks are the leading cause of pacemaker implantation globally, with an increased rate of implantation being attributed to an increase in global life expectancy and associated degeneration of cardiac conduction pathways [ 1 ]. These findings were supported by Mond and Proclemer who noted that implantation rates have increased in almost all countries [ 2 ] and the European Society of Cardiology (ESC), which noted that approximately 1 million devices are implanted on a global scale annually [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Keeping up the Pace: A Case of Complete Heart Block

Maraj¹,

Persad²,

Hinds³

2023

Cureus

View full text Add to dashboard Cite

We present the case of a 56-year-old lady who presented with symptomatic bradycardia and was outsourced for permanent pacemaker implantation. The discussion that follows highlights the growing need for permanent pacemakers globally and in Trinidad and Tobago, as well as the stepwise approach needed for investigating patients with symptomatic bradycardia. Finally, recommendations are made for policy changes needed at the national level.

show abstract

“…Atrioventricular block (AVB) is the most common indication for permanent pacemaker implantation (1)(2)(3)(4). Individuals requiring permanent pacemakers are generally older (3,5,6) with a mean age between 64 and 77 (5).…”

Section: Introductionmentioning

confidence: 99%

“…Individuals requiring permanent pacemakers are generally older (3,5,6) with a mean age between 64 and 77 (5). This is attributed to the fact that ageing is associated with cardiac conduction system fibrosis (1,4).…”

Section: Introductionmentioning

confidence: 99%

“…In younger individuals and/or healthy athletes, some degree of heart block may reflect mainly high vagal tone rather than a disease process in the conduction system (7,8). In other younger patients, a conduction defect may reflect disease processes other than fibrosis, e.g., sarcoidosis (1,4). There is, however, little data on the progression of disease in this specific patient group, raising the possibility that some younger patients with conduction system disease may not suffer the same risk as older patients with degenerative conduction disease.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A retrospective audit of young adults who received permanent pacemakers at a teaching hospital in the Western Cape, South Africa

Hugo,

Doubell,

Steyn

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

IntroductionWhile most pacemaker implantations occur in older individuals, younger patients also receive pacemakers. In these, degenerative conduction system disease is less likely to be the cause of atrioventricular block (AVB), with other diseases being more common. There is, however, a paucity of data on this group as well as on younger pacemaker recipients that have undergone pacemaker implantation for reasons other than AVB. The aim of this study was to perform an audit of young adult permanent pacemaker recipients.MethodThis was a retrospective record review, conducted in the Division of Cardiology at Tygerberg Hospital, Cape Town, South Africa. We included 169 adult patients between the ages of 18 and 60, who received permanent pacemakers between 2010 and 2020. A subgroup analysis of patients 55 years and younger was also performed.ResultsThird degree AVB was the most common indication for pacemaker implantation (n = 115; 68%), followed by high degree AVB (n = 23; 13.6%) and sick sinus syndrome (SSS; n = 14; 8.3%). A specific underlying cause for conduction system abnormalities was found in only 25.4% of patients (n = 43), with most of them being 55 years or younger (n = 32; 30.8% of patients ≤ 55 years). Specific causes that were identified included prosthetic valve implantation and/or valve repair (n = 14; 8.3%), myocardial infarction (n = 6; 3.6%), cardiac sarcoidosis (n = 5; 3.0%), coronary artery bypass grafting (n = 3; 1.8%), cardiomyopathy (n = 2; 1.2%), muscular dystrophy (n = 2; 1.2%), congenital heart disease (ventricular septal defect; atrioventricular septal defect; Tetralogy of Fallot; bicuspid aortic valve; n = 6; 3.6%), acute myocarditis (n = 1; 0.6%), atrial myxoma removal (n = 1; 0.6%), planned AV node ablation (n = 2; 1.2%), and following a previous stab in the chest (n = 1; 0.6%).ConclusionGiven that the mean age of our study population was high, the low number of identified underlying causes in the whole cohort (≤60 years) may reflect some AVB due to age related degeneration of the conductions system in the patients 56 to 60 years age, but also raises the possibility that these patients may be less likely to be extensively investigated for an underlying cause than those ≤55 years, where diseases such as sarcoidosis were more readily confirmed. As access to advanced diagnostic tools improves, the percentage of young pacemaker recipients with an underlying cause identified may increase.

show abstract

Causes of Heart Block in Young and Middle-Aged South Africans

Cited by 4 publications

References 20 publications

Electrophysiology practice in low- and middle-income countries: An updated review on access to care and health delivery

Electrophysiology practice in low- and middle-income countries: An updated review on access to care and health delivery

Keeping up the Pace: A Case of Complete Heart Block

A retrospective audit of young adults who received permanent pacemakers at a teaching hospital in the Western Cape, South Africa

Contact Info

Product

Resources

About