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Long-term results of patients with congenital complete atrioventricular block
1Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Insights
Congenital complete atrioventricular block in children often has a good prognosis. This study identified clinical features to help determine which patients might be at risk for sudden death.
Area of Science:
- Pediatrics
- Cardiology
- Genetics
Background:
- Congenital complete atrioventricular block (CCAVB) is rare but usually has a favorable prognosis.
- CCAVB can be associated with syncope, sudden death, or the need for cardiac pacing.
- Identifying children at risk for sudden death remains challenging.
Purpose of the Study:
- To examine clinical and laboratory features of children diagnosed with congenital complete atrioventricular block.
- To compare symptomatic and asymptomatic groups to identify potential risk factors for adverse outcomes.
- To evaluate the long-term prognosis and management of CCAVB in a pediatric population.
Main Methods:
- Retrospective analysis of hospital records from 39 children diagnosed with CCAVB between 1970 and 1990.
- Inclusion criteria: electrocardiogram consistent with complete heart block and a normally structured heart.
- Follow-up duration ranged from one month to 15 years; clinical and laboratory data were compared between symptomatic and asymptomatic patients.
Main Results:
- Of 39 children with CCAVB, 14 presented with symptoms (syncope, exercise intolerance, presyncope).
- Nine symptomatic patients underwent elective cardiac pacing and showed positive outcomes.
- Age at diagnosis varied, with a mean of 86.9 months.
Conclusions:
- Congenital complete atrioventricular block in children generally has a favorable prognosis.
- Further research is needed to definitively identify risk factors for sudden death in this population.
- Cardiac pacing can be an effective intervention for symptomatic children with CCAVB.
Abstract:
Congenital complete atrioventricular block is an uncommon disorder with a prognosis which is usually favorable. The disorder is sometimes associated with syncope, sudden death or cardiac pacing. It is difficult to determine the patients at risk of sudden death. In this retrospective study, hospital records of children who had been admitted to the Hacettepe University Children's Hospital between 1970-1990 for evaluation of complete heart block were examined. The study population, consisting of 39 children, 27 males and 12 females, had electrocardiograms consistent with complete heart block. These patients, diagnosed as having congenital complete A-V block, had an otherwise normally structured heart, and were followed up for a period of from one month to 15 years. Age at diagnosis ranged from 27 days to 17 years (mean: 86.9 +/- 48 months). Of the 14 patients with symptoms (five with syncope, eight with exercise intolerance and one with presyncope), nine were paced electively and have done well. Clinical and laboratory features of the asymptomatic and symptomatic groups were compared to evaluate potential risk factors.