Congenital Complete Atrioventricular Block

Friedman, Richard A.; Fenrich, Arnold L.; Kertesz, Naomi J.

doi:10.1046/j.1460-9592.2001.01681.x

Cited by 43 publications

(32 citation statements)

References 55 publications

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“…Sinus bradycardia may be caused by structural intracardiac abnormalities, such as left atrial isomerism, cardiac tumors, cardiomyopathies, or vagal stimulation [1,2]. AV dissociation can occur in association with structural heart defects, such as ventricular inversion or ltransposition of the great vessels, or as an isolated lesion: congenital complete atrioventricular block (CCAVB) [3]. Isolated CCAVB in the fetus is generally associated with the presence of maternal SS-A/Ro and/or SS-B/La antibodies, and its substrate is inflammatory injury of the fetal conduction system resulting in permanent damage of the AV node [4].…”

Section: Introductionmentioning

confidence: 99%

Transient Non-Autoimmune Fetal Heart Block

Breur

Oudijk²,

Stoutenbeek³

et al. 2005

Fetal Diagn Ther

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Objectives: Fetal heart block is a rare and irreversible condition associated with structural heart defects or maternal autoantibodies (SS-A/Ro and SS-B/La) resulting in permanent damage of the atrioventricular (AV) node. This is the first report of 4 cases with a transient fetal heart block in structurally normal hearts without maternal autoantibodies. Methods: A report on 4 patients seen within a 14-year period at one center with fetal heart block without intracardiac abnormalities or maternal autoantibodies. Results: Three patients were referred to our center with a fetal bradycardia (heart rate 70–85 bpm), between 20 and 33 weeks’ gestational age, and 1 for a ‘triple’ test at 16 weeks’ gestational age. Echocardiography showed a complete heart block in 2 fetuses, and a second-degree AV block in the other 2. Heart block had completely resolved at all following visits. Postnatal ECG recordings showed normal sinus rhythm in all patients. Echocardiographic evaluation at presentation and follow-up showed normal cardiac anatomy, without signs of hydrops or cardiac decompensation in all patients. All mothers tested negative on SS-A/Ro and SS-B/La autoantibodies. Conclusions: Fetal heart block can occur in the absence of structural heart defects and maternal autoantibodies to SS-A/Ro and SS-B/La. The origin of such heart block is unknown, but its course seems benign: none of the patients ever showed ventricular heart rates <55 bpm, signs of congestive heart failure or fetal hydrops. Heart block resolved spontaneously in all patients.

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Section: Introductionmentioning

confidence: 99%

Transient Non-Autoimmune Fetal Heart Block

Breur

Oudijk²,

Stoutenbeek³

et al. 2005

Fetal Diagn Ther

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“…Optimization of the cardiac index of VDD/DDD patients requires that atrial and ventricular contraction be appropriately timed [6,7,8, 10, 17]. Although, VVIR pacing in patients with congenital atrioventricular block could adequately respond in their physiological needs [18], the present study documented hemodynamic benefit, proven by Doppler-echo measurements of cardiac index, at the atrioventricular sequential pacing mode compared to VVIR pacing at the rest.…”

Section: Discussionmentioning

confidence: 62%

Cardiac Index and Exercise during VDD/DDD versus VVIR Pacing in Children

Başpınar¹,

Çeliker²,

Karagöz³

2006

Cardiology

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Twelve children with a VDD/DDD pacemaker during 100, 125, 150, 200 ms atrioventricular delays and VVIR pacing, cardiac index was measured at rest and evaluated by endurance time during exercise stress test. The optimal atrioventricular delay, which provides highest cardiac index, was 100 ms in three, 125 ms in two, and 150 ms in four and 200 ms in three patients. VDD/DDD pacing with different atrioventricular intervals resulted in a significantly higher cardiac index (6.70 ± 3.06, 6.49 ± 2.51, 6.15 ± 2.35, 6.37 ± 2.69 l/min/m², respectively) than VVIR pacing (5.25 ± 2.39 l/min/m²) at the rest. However, endurance times to treadmill exercise were similar in both the optimal atrioventricular delay (21.6 ± 3.7 min) and VVIR mode (22.4 ± 3.4 min) (p > 0.05).

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“…This uncertainty coupled with the fact that Ͼ24 hrs had elapsed from the time of the CVC placement until the patient's transfer influenced the decision to not administer systemic corticosteroids to this patient. The patient did not initially meet any of the class I indications for pacemaker insertion, although his CAVB did continue into the 7-to 14-day period as delineated for patients with postsurgical CAVB (8,9). Finally, his small size and hemodynamic stability allowed for more prolonged observation than might have been used under different circumstances.…”

Section: Discussionmentioning

confidence: 99%