Document Detail


Late recovery of atrioventricular conduction after pacemaker implantation for complete heart block in congenital heart disease: fact or fluke?
MedLine Citation:
PMID:  20690515     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Pacemaker implantation is a standard recommendation for patients with persistent complete heart block with congenital heart disease. This study was performed to determine the incidence and clinical significance of late recovery of atrioventricular (AV) conduction following pacemaker implantation. METHODS: A retrospective study of patients with congenital heart disease needing pacemaker implantation was performed between 1977 and 2008 at our institution. The postoperative course of all patients with complete heart block, in whom a permanent pacemaker was implanted, was followed on a semi-annual basis by clinical follow-up. RESULTS: A total of 56 patients with complete heart block underwent pacemaker implantation. Indications for pacemaker implantation could be categorized in primary AV conduction block (n = 28 ; 50%) and surgically-induced AV conduction block (n = 28 ; 50%). After pacemaker insertion, recovery of AV conduction was recognized in two patients. The first patient was operated for atrial septal defect type ostium secundum with complete heart block preoperatively. AV block resolved 2 days after pacemaker implantation. The second patient underwent mitral valve replacement. Postoperatively, the patient developed second degree heart block, which progressed 3 years later into complete heart block. A recovery of AV conduction was seen 7.5 years later. In these patients, no late recurrence of complete heart block was found during follow-up after 8 and 4 months, respectively. CONCLUSIONS: Recovery of AV conduction was observed in one patient with primary AV conduction block and in one patient with complete heart block after congenital heart surgery. Lifelong cardiac pacing in these specific subsets of patients may not be necessary.
Authors:
J De Raet; F Rega; B Meyns
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta chirurgica Belgica     Volume:  110     ISSN:  0001-5458     ISO Abbreviation:  Acta Chir. Belg.     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370571     Medline TA:  Acta Chir Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  323-7     Citation Subset:  IM    
Affiliation:
Department of Pediatric and Congenital Cardiac Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. jan.deraet@uzleuven.be
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MeSH Terms
Descriptor/Qualifier:
Atrioventricular Block / therapy*
Child
Child, Preschool
Electrocardiography
Follow-Up Studies
Heart Defects, Congenital / complications*
Humans
Pacemaker, Artificial*
Recovery of Function*
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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