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Paroxysmal atrioventricular block in young patients
M S Silvetti1, G Grutter, V Di Ciommo
1Cardiac Arrhythmias Service, Cardiology and Heart Surgery Department, Bambino Gesù Pediatric Hospital, Piazza S. Onofrio 4, 00165, Rome, Italy. silvetti@opbg.net
Pediatric Cardiology
|November 10, 2004
Summary
Paroxysmal atrioventricular block (PAVB) is a rare pediatric arrhythmia. Permanent pacemaker implantation effectively treated symptoms, even in asymptomatic patients with congenital heart disease.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Autonomic Nervous System Function
Background:
- Paroxysmal atrioventricular block (PAVB) is infrequently documented in pediatric populations.
- Understanding PAVB's clinical presentation and risk factors in children is crucial for timely intervention.
Purpose of the Study:
- To characterize the clinical features, diagnostic methods, and treatment outcomes of PAVB in a pediatric cohort.
- To investigate the role of autonomic dysfunction and congenital heart disease (CHD) in pediatric PAVB.
Main Methods:
- Retrospective analysis of 17 pediatric patients diagnosed with PAVB.
- Utilized Holter monitoring and tilt testing for PAVB diagnosis.
- Assessed clinical presentation, ECG findings, and outcomes following pacemaker implantation.
Main Results:
- 17 pediatric patients (mean age 9.6 years) with PAVB were identified.
- Syncope/presyncope occurred in 7 patients; normal ECG was more frequent in symptomatic cases.
- 13 patients received permanent pacemakers, including asymptomatic CHD patients with severe bradycardia.
- PAVB persisted in 91% of paced patients, but symptoms resolved with pacing.
Conclusions:
- PAVB is a rare pediatric arrhythmia potentially linked to autonomic nervous system dysfunction.
- Permanent pacemaker implantation is an effective treatment for symptomatic and selected asymptomatic pediatric PAVB patients.
- Early diagnosis and intervention, including pacing, can prevent recurrent symptoms and improve outcomes.