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Documented transient third-degree atrioventricular block and asystole in a child with familial dysautonomia
Amichay Rotstein1, Joel Charrow, Barbara J Deal
1Division of Pediatric Cardiology, Schneider Children's Medical Center of Israel, Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University, 14 Kaplan Street, Petah-Tikva 49202, Israel. amichay@clalit.org.il
Abstract:
An 11-year-old boy with familial dysautonomia presented with palpitations. Continuous 24-h Holter monitoring revealed intermittent high-grade atrioventricular block and asystole. The unopposed parasympathetic tone in patients with dysautonomia may make them susceptible to bradycardia and atrioventricular block. We recommend routine 24-h Holter monitoring screening and, when indicated, consideration of pacemaker implantation to reduce the high risk of sudden death phenomena in this patient population.
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