Atrioventricular Block in Children With Multisystem Inflammatory Syndrome

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Children infected with SARS-CoV-2 are susceptible to multisystem inflammatory syndrome (MIS-C).
• Cardiovascular complications are common in MIS-C, but data on arrhythmias are limited.
• Ventricular dysfunction and coronary dilation are frequent findings in pediatric MIS-C patients.

Purpose of the Study:

• To investigate the incidence and characteristics of arrhythmic complications in children and young adults with MIS-C.
• To identify risk factors associated with the development of arrhythmias in MIS-C patients.
• To evaluate the clinical significance of electrocardiogram (ECG) findings in MIS-C.

Main Methods:

• Retrospective cohort study of patients aged ≤21 years admitted with MIS-C.
• Analysis of demographic data, ECG findings, echocardiogram results, and hospital course.
• Detailed review of cardiac rhythm and conduction abnormalities.

Main Results:

• ECG anomalies were observed in 56% of MIS-C patients.
• First-degree atrioventricular block (AVB) occurred in 20%, progressing to high-grade AVB in 4 patients.
• Ventricular dysfunction and ICU admission were associated with AVB; no ventricular arrhythmias were noted.

Conclusions:

• Children with MIS-C are at risk for atrioventricular conduction disease, especially those with ventricular dysfunction and requiring ICU care.
• ECG monitoring for PR prolongation is recommended in MIS-C patients.
• Continuous telemetry may be necessary for patients with first-degree AVB due to the risk of progression.