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Summary
Idiopathic bilateral bundle branch fibrosis is the most frequent cause of permanent atrioventricular block, accounting for 33% of cases. Other causes include ischemic damage, calcific atrioventricular block, and cardiomyopathies.
Area of Science:
- Cardiology
- Pathology
Background:
- Permanent atrioventricular (A-V) block is a significant clinical condition with diverse underlying causes.
- Understanding the etiology of A-V block is crucial for diagnosis and management.
Purpose of the Study:
- To identify and quantify the common causes of permanent A-V block in a cohort of 177 patients.
- To delineate the spectrum of idiopathic bundle branch fibrosis, including Lev's and Lenègre's diseases.
Main Methods:
- Retrospective analysis of 177 cases of permanent A-V block.
- Categorization of causes based on pathological findings and clinical data.
Main Results:
- Idiopathic bilateral bundle branch fibrosis was the most common cause (33%), encompassing Lev's and Lenègre's diseases.
- Ischemic damage accounted for 17% of cases, often following septal infarction.
- Calcific A-V block (10%) and cardiomyopathies (14%) were other significant etiological categories.
- Numerous other rare causes were identified, including tumors, congenital defects, and iatrogenic damage.
Conclusions:
- Idiopathic bilateral bundle branch fibrosis is the predominant cause of permanent A-V block.
- A comprehensive etiological workup is necessary for chronic A-V block, considering both common and rare causes.