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Complete congenital heart block. Report of 35 cases
Insights
Congenital complete atrioventricular block, though uncommon, requires long-term supervision. Most patients will eventually need permanent pacing, highlighting the importance of ongoing cardiac care.
Area of Science:
- Pediatrics
- Cardiology
- Congenital Heart Disease
Background:
- Congenital complete atrioventricular block is a rare condition.
- The long-term prognosis is generally considered favorable.
- This study reviews a cohort of patients with this diagnosis.
Purpose of the Study:
- To describe the clinical characteristics and outcomes of patients with congenital complete atrioventricular block.
- To identify risk factors associated with a poorer prognosis.
- To inform management strategies and the need for long-term follow-up.
Main Methods:
- Retrospective review of 35 patients diagnosed with congenital complete atrioventricular block.
- Analysis of patient demographics, clinical presentation, presence of associated heart disease, and interventions.
- Evaluation of outcomes including need for permanent pacing and mortality.
Main Results:
- The patient cohort ranged in age from 12 days to 85 years, with most diagnosed under 20.
- Six patients had accompanying heart disease; early infancy symptoms indicated a poorer prognosis.
- Permanent pacing was required in 21 patients (three neonates); one unpaced patient died at age 5.
Conclusions:
- Congenital complete atrioventricular block necessitates lifelong monitoring.
- A significant proportion of patients require permanent pacemaker implantation before age 50.
- Early symptomatic presentation is a critical risk factor requiring vigilant management.
Abstract:
Congenital complete atrioventricular block is uncommon, and the outlook is usually regarded as favourable. Thirty-five patients with congenital heart block are presented. There was no obvious sex difference and their ages ranged from 12 days to 85 years, though most were under the age of 20 years when first seen. Accompanying heart disease was noted in six, but presentation with symptoms in early infancy was a more serious risk factor in our experience. Permanent pacing was required in 21, three of whom were neonates. One of the 14 unpaced patients died unexpectedly at the age of 5 years. Long term supervision is necessary, as most will require permanent pacing before their 50th birthday.