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Sinus node function in children with congenital complete atrioventricular block.

Gertie C M Beaufort-Krol1, Ymkje Stienstra, Margreet Th E Bink-Boelkens

  • 1Beatrix Children's Hospital, Division of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|June 7, 2007
PubMed
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Children with congenital complete atrioventricular block (CCAVB) have normal sinus node function. This finding supports the safe use of single-lead VDD pacemakers in pediatric patients with CCAVB.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Congenital complete atrioventricular block (CCAVB) frequently necessitates pacemaker implantation in children.
  • Single-lead VDD pacing is a preferred method for these patients, but it requires intact sinus node function.

Purpose of the Study:

  • To evaluate sinus node function in children diagnosed with CCAVB.
  • To determine the suitability of VDD pacing in this pediatric population.

Main Methods:

  • Longitudinal assessment of sinus rate in 36 children with CCAVB and normal cardiac anatomy.
  • Evaluation included 12-lead ECG, Holter monitoring, and exercise testing at regular intervals.
  • Sinus rates were analyzed across different age groups and during varying physiological conditions.

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Main Results:

  • Sinus rhythm rates remained within normal age-specific ranges throughout the follow-up period (mean 10.6 years).
  • Holter recordings showed normal lowest and highest sinus rates.
  • Exercise tests demonstrated a physiological increase in mean sinus rate from rest (92 bpm) to maximal exercise (171 bpm).

Conclusions:

  • Sinus node function is preserved in children with CCAVB.
  • The normal chronotropic response to exercise supports the safety and efficacy of single-lead VDD pacemaker implantation in these children.