High Degree AV Block in Infants

  • Agus Cahyono Universitas Surabaya
Keywords: AV block, bradycardia, pacemaker implantation

Abstract

Background: Atrioventricular (AV) block in children may pose a challenge for phycisians. However, it can be detected with careful physical examination.

Case illustration: A 4 month old infant presented with bradycardia that did not improve during observation period. Her electrocardiography (ECG) showed complete atrioventricular block and her echocardiography showed secundum atrial septal defect (ASD)  and patent ductus arteriosus (PDA). Her father’s ECG showed first degree AV block. She was recovered well after pacemaker implantation and PDA ligation.  

Conclusion: An infant who suffered from complete AV block was successfully treated with pacemaker.

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References

1 Jaeggi ET, Hamilton RM, Silverman ED, Zamora SA, Hornberger LK. Outcome of children with fetal, neonatal or childhood diagnosis of isolated congenital atrioventricular block. JACC. 2002;39(1):130–7.
2 Mall P, Shah I. A 9 months old child with asymptomatic bradycardia. Pediatric Oncall Journal. 2020;17(2):68–9.
3 Yantie NPVK, Gunawijaya E, Suradipa IW, Gustawan IW. Asymptomatic cardiac rhythm abnormality in children with dengue virus infection. Bali Med J. 2016;5(2):351–4
4 Kusumoto FM, Schoenfeld MH,Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ. Guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. J AM Coll Cardiol. 2018. http://www.onlinejacc.org/guidelines/bradycardia
5 Baruteau AE, Fouchard S, Behaghel A, Mabo P, Villain E, Thambo JB, Marcon F, Gournay V, Rouault F, Chantepie A, et al. Characteristics and long-term outcome of nonimmune isolated atrioventricular block diagnosed in utero or early childhood: a multicentre study. European Heart Journal. 2012;33:622–9.
6 Lust B. Child Language. Cambridge University Press;2006
7 Hazebroek MR, Everaerts K, Heymans S. Diagnostic approach of myocarditis: strike the golden mean. Neth Heart J. 2014;22:80–4.
8 Dancea AB. Myocarditis in infants and children: A review for the paediatrician. Paediatr Child Health. 2001;6(8):543–5.
9 El-Assaad I, Hood-Pishchany MI, Kheir J, Mistry K, Dixit A, Halyabar O, Mah DY, Meyer-Macaulay C, Cheng H. Complete heart block, severe ventricular dysfunction, and myocardial inflammation in a child with COVID-19 infection. J Am Coll Cardiol Case Rep. 2020;2:1351–5.
10 Goodman DJ, Harrison DC, Cannom DS. Atrioventricular conduction in patients with incomplete endocardial cushion defect. Circulation. 1974;49:631–7.
11 Mehta AV, O’Riordan AC, Sanchez GR, Black IFS. Acquired nonsurgical complete atrioventricular block in a child with endocardial cushion defect. Clin. Cardiol. 1982;5:603–5.
12 Morton JB, Sanders P, Vohra JK, Sparks PB, Morgan JG, Spence SJ, Grigg LE, Kalman JM. Effect of chronic right atrial stretch on atrial electrical remodeling in patients with an atrial septal defect. Circulation. 2003;107:1775–82.
13 Douglas J. Schneider, MD; John W. Moore. Patent ductus arteriosus. Circulation. 2006;114:1873–82.
14 Benson DW, Silberbach GM, Kavanaugh-McHugh A, Cottrill C, Zhang Y, Riggs S, Smalls O, Johnson MC, Watson MS, Seidman JG, Seidman CE, Plowden J, Kugler JD. Mutations in the cardiac transcription factor NKX2.5 affect diverse cardiac developmental pathways. J. Clin. Invest. 1999;104:1567–73.
15 Pashmforoush M, Lu JT, Chen H, St. Amand T, Kondo R, Pradervand S, Evans SM, Clark B, Feramisco JR, Giles W, Yen Ho S, Benson DW, Silberbach M, Shou W, Chien KR. Nkx2-5 pathways and congenital heart disease: loss of ventricular myocyte lineage specification leads to progressive cardiomyopathy and complete heart block. Cell. 2004;117:373–86.
16 Gutierrez-Roelens I, De Roy L, Ovaert C, Sluysmans T, Devriendt T, Brunner HG, Vikkula M. A novel CSX/NKX2-5 mutation causes autosomal dominant AV block: are atrial fibrillation and syncopes part of the phenotype? European Journal of Human Genetics. 2006;14:1313–6.
17 Wang DW, Viswanathan PC, Balser JR, George AL, Benson DW. Clinical, genetic, and biophysical characterization of SCN5A mutations associated with atrioventricular conduction block. Circulation. 2002;105:341–6.
18 Baruteau AE, Pass RH, Thambo JB, Behaghel A, Le Pennec S, Perdreau E, Combes N, Liberman L, McLeod CJ. Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management. Eur J Pediatr. 2016;175:1235–48.
Published
2022-06-30
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How to Cite
Cahyono, A. (2022). High Degree AV Block in Infants. Indonesian Journal of Cardiology, 43(3), 116-22. https://doi.org/10.30701/ijc.1244