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Chronotropic competence of the sinus node in congenital complete heart block
A Menon1, E D Silverman, R M Gow
1Department of Pediatrics, The Hospital for Sick Children, and the University of Toronto, Ontario, Canada.
The American Journal of Cardiology
|November 17, 1998
Insights
Children exposed to anti-Ro antibodies can develop sinus node disease. Congenital complete heart block may also present with sinus node dysfunction, specifically chronotropic incompetence during exercise.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Neonatal Immunology
Background:
- Maternal autoantibodies, such as anti-Ro antibodies, can cross the placenta.
- Neonatal heart block is a known complication of transplacental antibody exposure.
- Sinus node dysfunction can manifest in various pediatric cardiac conditions.
Purpose of the Study:
- To investigate the prevalence and characteristics of sinus node disease in children with transplacental anti-Ro antibody exposure.
- To evaluate sinus node function during exercise in children diagnosed with congenital complete heart block.
Main Methods:
- Resting electrocardiogram (ECG) analysis in 2 children with transplacental anti-Ro antibody exposure and 1:1 atrioventricular conduction.
- Treadmill exercise testing in 28 patients with congenital complete heart block.
Main Results:
- Sinus node disease was identified in 2 children exposed to anti-Ro antibodies.
- Chronotropic incompetence of the sinus node was observed in 3 out of 28 patients (10.7%) with congenital complete heart block during exercise testing.
Conclusions:
- Transplacental anti-Ro antibody exposure is associated with sinus node disease in neonates.
- Sinus node dysfunction, including chronotropic incompetence, is a potential complication in pediatric patients with congenital complete heart block.
Abstract:
Electrocardiograms taken at rest of 2 children with transplacental exposure to anti-Ro antibody but 1:1 atrioventricular conduction demonstrated sinus node disease. Treadmill exercise testing of 28 patients with congenital complete heart block found 3 patients with chronotropic incompetence of the sinus node.