Corticosteroids in the management of sinoatrial block

This report presented our experience in the treatment of sinoatrial (S-A) conduction disturbances with corticosteroids. Three patients with intermittent second-degree S-A block who failed to respond to atropine and isoproterenol were treated with prednisone for 6-17 weeks. Sustained improvement in S-A conduction following prednisone administration was confirmed by repeated Holter monitoring on and off therapy. Two patients eventually regained permanent sinus rhythm, while therapy led to marked diminution in S-A block in the 3rd patient. The possible mechanisms by which steroids may improve S-A conduction are discussed. Our observation is based on a small case series, each patient serving as his own control, and as such constitutes an indication for further confirmatory studies.