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Atrial Septal Defect (ASD) Repair Unveiling an Unusual Conduction Conundrum: A Wenckebach Case Report
Matthew J Van Ligten1, Douglas E Rappaport2, Lauren B Querin2
1Emergency Medicine, Mayo Clinic Alix School of Medicine, Scottsdale, USA.
Insights
Atrial septal defects (ASDs) increase stroke risk. A rare case shows a patient developing Mobitz type 1 heart block after a less invasive percutaneous ASD closure, highlighting potential complications.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Electrophysiology
Background:
- Atrial septal defects (ASDs) are common congenital heart anomalies.
- Untreated ASDs can lead to stroke and pulmonary hypertension.
- Percutaneous intervention offers a safer alternative to surgical repair for ASDs.
Observation:
- A patient with a congenital atrial septal defect underwent percutaneous intervention.
- Following the procedure, the patient developed a new-onset second-degree atrioventricular (AV) block.
- The specific rhythm identified was Mobitz type 1 (Wenckebach).
Findings:
- Percutaneous closure of ASDs, while generally safe, can precipitate adverse cardiac events.
- New-onset Mobitz type 1 AV block is a potential complication following percutaneous ASD intervention.
- This case highlights an uncommon but significant electrophysiological disturbance post-procedure.
Implications:
- Awareness of potential cardiac rhythm complications is crucial for clinicians managing patients post-percutaneous ASD intervention.
- Monitoring for bradyarrhythmias, including AV block, is important in the follow-up care of these patients.
- Further research may elucidate the mechanisms and optimal management strategies for post-procedural AV block in ASD patients.
Abstract:
Atrial septal defects are a common congenital malformation that can lead to an elevated risk for stroke due to the bypass of the lungs by deep vein thrombosis, as well as the expected repercussions of pulmonary hypertension if left untreated. Surgical intervention is definitive; however, recent advancements in treatment options, such as percutaneous intervention, represent a safer and equally effective way to treat this congenital complication. While safer, percutaneous interventions can also lead to adverse events that may force patients to present to the emergency department. Here, we present a unique case of a patient with congenital atrial septal defect status post-percutaneous intervention who developed a new-onset second-degree AV block, Mobitz type 1 Wenckebach rhythm.
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