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Complete heart block in an adult with corrected transposition of the great arteries treated with permanent pacemaker
Thorax
|August 1, 1979
Insights
Corrected transposition of the great arteries can lead to severe heart block. This case highlights the need for pacemaker implantation due to progressive atrioventricular conduction disturbances in patients with this congenital heart defect.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Electrophysiology
Background:
- Corrected transposition of the great arteries (cTGA) is a complex congenital heart defect.
- Patients with cTGA are at increased risk for developing atrioventricular (AV) conduction abnormalities.
- Progressive AV block can lead to significant morbidity and mortality.
Observation:
- A 53-year-old patient with a history of cTGA presented with symptomatic complete heart block and syncope.
- Initial management involved temporary endocardial pacing of the morphologically left ventricle.
- A permanent epicardial pacemaker was subsequently implanted.
Findings:
- This case illustrates the progressive nature of AV conduction disturbances in cTGA.
- Complete heart block developed in adulthood, necessitating pacemaker implantation.
- The anatomical arrangement in cTGA predisposes to conduction system disease.
Implications:
- Early recognition and management of AV block are crucial in cTGA patients.
- Pacemaker therapy is an effective treatment for symptomatic heart block in this population.
- Understanding the long-term electrophysiological consequences of cTGA is vital for patient care.
Abstract:
A 53-year-old patient with corrected transposition of the great arteries developed complete heart block with fainting episodes. After temporary pacing through the endocardium of the venous (anatomically left) ventricle, a permanent epicardial pacemaker was implanted. This case shows the progressive nature of the atrioventricular conduction disturbances, which are very common in association with this congenital cardiac anomaly.