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Complete atrioventricular block due to multisystem inflammatory syndrome in children: a case report

Anisa Rahmadhany1, Rubiana Sukardi2, Sarah Rafika Nursyirwan1

  • 1Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

The Turkish Journal of Pediatrics
|December 30, 2022
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) can cause persistent cardiac conduction problems. Complete atrioventricular block following SARS-CoV-2 infection may last for months, requiring long-term management.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Electrophysiology

Background:

  • Cardiac involvement is a known complication of multisystem inflammatory syndrome in children (MIS-C).
  • Conduction system abnormalities, specifically atrioventricular (AV) block, are reported but remain uncommon in MIS-C.
  • The long-term sequelae of cardiac manifestations in MIS-C are not well-established.

Observation:

  • A 2-year-old girl with SARS-CoV-2 infection developed complete AV block, meeting MIS-C criteria.
  • Despite a 2-week observation period and temporary pacing during the SARS-CoV-2 convalescence phase, the complete AV block persisted.
  • The patient's intrinsic junctional escape rate was low (40 beats/minute), necessitating intervention.

Findings:

  • A dual-chamber epicardial permanent pacemaker was implanted to ensure atrial-ventricular synchrony and hemodynamic stability.
  • Long-term follow-up revealed persistent complete AV block 9 months post-SARS-CoV-2 infection.
  • This case highlights the potential for prolonged cardiac conduction disturbances in MIS-C.

Implications:

  • Complete AV block in MIS-C can be a persistent condition requiring extended monitoring and management.
  • This case contributes valuable data to the understanding of the natural history of cardiac complications following SARS-CoV-2 infection in children.
  • Further research is needed to elucidate the mechanisms and long-term outcomes of cardiac conduction abnormalities in MIS-C.
Abstract

Keywords:
MIS-Ccomplete AV Blockpermanent pacemaker

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