Etiology and device therapy in complete atrioventricular block in pediatric and young adult population: Contemporary review and new perspectives

Abstract

Complete atrioventricular block (CAVB) is a total dissociation between the atrial and ventricular activity, in the absence of atrioventricular conduction. Several diseases may result in CAVB in the pediatric and young-adult population. Permanent right ventricular (RV) pacing is required in permanent CAVB, when the cause is neither transient nor reversible. Continuous RV apical pacing has been associated with unfavorable outcomes in several studies due to the associated ventricular dyssynchrony. This study aims to summarize the current literature regarding CAVB in the pediatric and young adult population and to explore future treatment perspectives.cardiac-resynchronization therapy, complete AV block, pacemaker, third-degree AV block, young adults | INTRODUCTIONThird-degree atrioventricular block (AVB) or complete AV block (CAVB) is an arrhythmia with complete dissociation between atrial and ventricular activity, without evidence of AV conduction (Figure 1). According to American or European Guidelines, 1 a permanent pacemaker (PM) is indicated in CAVB, provided that the cause is neither transient nor reversible. Given their life expectancy, significant challenges may be faced when evaluating children, young or middle-aged adults with CAVB, since choosing the best pacing strategy is of paramount importance. Permanent CAVB requires permanent right ventricular (RV) stimulation, which in some cases may lead to ventricular dysfunction due to ventricular

The risk of pediatric cardiovascular diseases in offspring born to mothers with systemic lupus erythematosus: a nationwide study

“…Among arrhythmic disorders, we identified nine cases of thirddegree AV block, with an estimated incidence of 1 per 5,000 live births, which was higher than in a previous study (20). The risk of third-degree AV block was 10-fold higher in the SLE mother group.…”

Recurrent cardiac arrest and complete atrioventricular block due to idiopathic coronary vasospasm: A case report

“…Complete atrioventricular block (CAVB) is a life-threatening condition that requires prompt diagnosis and treatment. The most common causes of CAVB are degenerative changes of the conduction system, myocardial infarction, cardiac surgery, and drugs [ 1 ]. Coronary spasm is a rare cause of CAVB that can be triggered by various factors such as emotional stress, hyperventilation, cold exposure, smoking, and cocaine use.…”

Severe cardiac conduction disease associated with titin gene mutation

“…In these, progressive cardiac conduction disease has sometimes been seen and associated mutations have been identified in genes including SCN1B, SCN5A, SCN10A, TRPM4, and KCNK17. Additionally, abnormalities in NKX2.5 and Tbx5 have been associated with conduction abnormalities at times with congenital heart disease 1,2 …”

“…Additionally, abnormalities in NKX2.5 and Tbx5 have been associated with conduction abnormalities at times with congenital heart disease. 1,2 Mutations in the Titin (TTN) gene is one of the leading causes of dilated cardiomyopathy (DCM) in adults and has also been associated with atrial fibrillation (AF). 3,4 There has not been a prior association with complete heart block or other primary conduction disease.…”