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[Congenital complete atrio-ventricular block].

E Villain1

  • 1Département de pédiatrie, hôpital Necker-Enfants malades, Paris. elisabeth.villain@nck.ap-hop-paris.fr

Archives Des Maladies Du Coeur Et Des Vaisseaux
|July 13, 2005
PubMed
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Congenital complete atrio-ventricular block (AV block) requires pacemaker implantation for children with symptoms or very slow heart rates. Pediatric pacing offers satisfactory results, enabling most children to lead normal lives despite potential complications.

Area of Science:

  • Cardiology
  • Pediatrics
  • Electrophysiology

Context:

  • Congenital complete atrio-ventricular block (AV block) is a rare condition with unclear origins, potentially due to anatomical anomalies or maternal antibodies causing fetal myocarditis.
  • The diagnosis of congenital AV block can be challenging when identified later in childhood.

Purpose:

  • To outline the indications, treatment strategies, and outcomes of pacemaker implantation in children diagnosed with congenital complete AV block.
  • To discuss the surgical approaches (epicardial vs. endocavitary) and pacing modes (dual-chamber vs. ventricular) used in pediatric patients.

Summary:

  • Pacemaker implantation is the sole treatment for congenital complete AV block, indicated for cardiac failure, syncope, or asymptomatic children with heart rates below 50 bpm.
  • Treatment strategies vary based on age and weight, utilizing epicardial pacing for younger children and endocavitary pacing for older children.

Related Experiment Videos

  • Pacing modes include dual-chamber pacing to restore sinus node function or ventricular pacing for rate control, with generally satisfactory outcomes despite potential complications.

    • Impact:

    • Pediatric pacemaker implantation for congenital complete AV block leads to satisfactory outcomes, allowing the majority of children to lead normal lives.
    • Early identification and appropriate pacing mitigate risks of syncope, sudden death, and cardiac dysfunction in affected children.
    • While complications like thrombosis and infection exist, advancements in pacing techniques improve long-term results and quality of life for pediatric patients with AV block.