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Published on: February 11, 2022
A case of pause-dependent atrioventricular block with ventricular arrhythmias following redo Bentall procedure
Mohammed Mhanna1, Denice Hodgson-Zingman1, Olshansky Brian1
1University of Iowa Carver College of Medicine, Iowa City, USA.
Abstract:
A 63-year-old male with prior aortic valve replacement and Bentall procedure for E. faecalis endocarditis developed paroxysmal atrioventricular (AV) block after repeat Bentall surgery. Telemetry demonstrated PVC-triggered phase 4 block leading to high-grade AV block, prolonged pauses, and polymorphic ventricular tachycardia. A temporary permanent pacemaker was implanted, followed by ventricular leadless pacemaker placement. This case highlights the malignant potential of phase 4 block, particularly when combined with postoperative conduction system disease, and underscores the importance of early recognition and pacing support.
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