| Reversible infra-Hisian atrioventricular block in acute myocarditis. | |
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MedLine Citation:
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PMID: 11771189 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Symptomatic second- or third-degree atrioventricular (AV) block at any anatomical level is a class I indication for permanent pacemaker implantation. We describe a 44-year-old male with acute viral myocarditis who suffered from syncope followed by a seizure attack associated with AV conduction disturbance. His initial electrocardiogram in our emergency room revealed sinus tachycardia with 2:1 AV conduction and a right bundle branch block QRS morphology with a ventricular rate of 60 beats/min. Because of episodic slowing of the heart rate below 40 beats/min, he received 1 mg atropine intravenously which increased the atrial rate but further worsened the AV conduction, resulting in ventricular asystole for more than 30 seconds associated with loss of consciousness and seizure-like activity. He was immediately paced transcutaneously and transferred to the catheterization laboratory to receive temporary transvenous cardiac pacing. The cardiac catheterization study showed a normal coronary angiogram and very mild diffuse hypokinesis. Electrophysiological studies revealed advanced infra-Hisian AV block. The infra-Hisian AV block, however, resolved rapidly in 2 days. The patient did not receive a permanent pacemaker and remained asymptomatic with normal electrocardiogram over 1 year of follow-up. We suggest that symptomatic infra-Hisian AV block due to viral myocarditis can be reversible, and implantation of a permanent pacemaker may not be necessary. |
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Authors:
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T H Yu; G F Guo; M C Chen; C H Yang |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Chang Gung medical journal Volume: 24 ISSN: 2072-0939 ISO Abbreviation: Chang Gung Med J Publication Date: 2001 Oct |
Date Detail:
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Created Date: 2001-12-28 Completed Date: 2002-01-10 Revised Date: 2008-12-16 |
Medline Journal Info:
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Nlm Unique ID: 101088034 Medline TA: Chang Gung Med J Country: China (Republic: 1949- ) |
Other Details:
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Languages: eng Pagination: 651-6 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan, R.O.C. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Electrocardiography Heart Block / etiology* Humans Male Myocarditis / complications* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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