Congenital Complete Heart Block—To Stimulate (When?) or Not to Stimulate?
Abstract
:1. Introduction
- A detailed medical history needs to be collected in order to answer the question of whether there are any symptoms (syncope, exercise intolerance, palpitations and symptoms of heart failure).
- A physical examination ought to check the signs of bradycardia and heart failure.
- Echocardiography should be performed to assess the presence of valvular heart disease and to assess the size and function of the heart. In some patients, long-term AV block may cause left ventricular dyssynchrony.
- An exercise ECG should be performed and chronotropic capacity and exercise tolerance should be assessed.
- ECG monitoring should use the Holter method to assess the average, minimum and maximum rhythm rates and to assess whether there is ventricular arrhythmia, inhibitions and interruptions in the leading rhythm and QT interval duration [11].
2. Case Presentation
2.1. Medical History
2.2. Diagnostics
2.3. Management
2.4. Follow-Up
3. Discussion
- The occurrence of the symptoms mentioned earlier;
- Left ventricular systolic dysfunction;
- A number of pauses > 3 times the basic rhythm (e.g., in our case the average cycle is 1330 ms, so the pause > 3.990 ms (>~4 s);
- An escape rhythm with wide QRS complexes;
- A prolonged QTc interval; it should be remembered that Bazett’s correction rule overestimates QTc for rhythms above 100 bpm and underestimates QTc for rhythms below 50 bpm;
- The occurrence of complex ventricular arrhythmias;
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Kukla, P.; Podlejska, B.; Wiliński, J. Congenital Complete Heart Block—To Stimulate (When?) or Not to Stimulate? Healthcare 2024, 12, 1158. https://doi.org/10.3390/healthcare12121158
Kukla P, Podlejska B, Wiliński J. Congenital Complete Heart Block—To Stimulate (When?) or Not to Stimulate? Healthcare. 2024; 12(12):1158. https://doi.org/10.3390/healthcare12121158
Chicago/Turabian StyleKukla, Piotr, Beata Podlejska, and Jerzy Wiliński. 2024. "Congenital Complete Heart Block—To Stimulate (When?) or Not to Stimulate?" Healthcare 12, no. 12: 1158. https://doi.org/10.3390/healthcare12121158
APA StyleKukla, P., Podlejska, B., & Wiliński, J. (2024). Congenital Complete Heart Block—To Stimulate (When?) or Not to Stimulate? Healthcare, 12(12), 1158. https://doi.org/10.3390/healthcare12121158