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Clinical Cardiology Mar 2018
Topics: Atrioventricular Block; Atrioventricular Node; Electrocardiography; Heart Rate; Humans
PubMed: 29460961
DOI: 10.1002/clc.22874 -
Medicina 2021Chagas disease is endemic in Latin America and remains a regional problem despite improvements in environmental health conditions that have helped to control its...
Chagas disease is endemic in Latin America and remains a regional problem despite improvements in environmental health conditions that have helped to control its transmission. To know more about its prevalence in heart disease patients, we carried out a survey in our national (El Salvador) reference hospital. We reviewed the Chagas Lab's records 2013-2015 to find out how many of the patients admitted to the Hospital's Heart Unit were serologically positives for Trypanosoma cruzi infection and which the associated diagnoses were. A total of 1472 patients were tested along the 36-month study period. Out of 557 (37.8%) patients with positive serology for Chagas infection, 97 (17.4%) were eventually admitted to the Heart Unit. Among these 97 Chagas infected patients with heart disease, 40 (41.2%) met the criteria for permanent pacemaker placement, while only 13 of 191 (6.8%) patients with non-chagasic heart disease met these criteria. The frequency of heart atrioventricular block associated with Trypanosoma cruzi infection was higher than frequencies reported in South American studies.
Topics: Atrioventricular Block; Chagas Disease; El Salvador; Humans; Latin America; Trypanosoma cruzi
PubMed: 33906132
DOI: No ID Found -
Circulation. Genomic and Precision... Apr 2023Complete atrioventricular block (CAVB) is a major reason for implantation of permanent pacemakers, but knowledge of CAVB inheritance is sparse. This nationwide study...
BACKGROUND
Complete atrioventricular block (CAVB) is a major reason for implantation of permanent pacemakers, but knowledge of CAVB inheritance is sparse. This nationwide study aimed to determine the occurrence of CAVB in first-, second-, and third-degree relatives (full siblings, half-siblings, and cousins).
METHODS
The Swedish multigeneration register was linked to the Swedish nationwide patient register for the period 1997 to 2012. All Swedish full sibling, half-sibling, and cousin pairs born to Swedish parents between 1932 and 2012 were included. Competing risks and time-to-event, subdistributional hazard ratios (SHRs) according to Fine and Gray and hazard ratios using Cox proportional hazards model were estimated using robust SEs and considering the relatedness of relatives (full siblings, half-siblings, cousins). Additionally, odds ratios (ORs) for CAVB were calculated for traditional cardiovascular comorbidities.
RESULTS
The study population (N=6 113 761) consisted of 5 382 928 full siblings, 1 266 391 half-siblings, and 3 750 913 cousins. In total, 6442 (0.11%) unique individuals were diagnosed with CAVB. Of these, 4200 (65.2%) were males. SHRs for CAVB were 2.91 for full siblings (95% CI, 2.43-3.49), 1.51 for half-siblings (0.56-4.10), and 3.54 for cousins (1.73-7.26) of affected individuals. Age-stratified analysis showed higher risk in young individuals born from 1947 to 1986: SHR, 5.30 (3.78-7.43) for full siblings, SHR, 3.30 (1.06-10.31) for half-siblings, and SHR, 3.15 (1.39-7.17) for cousins. Similar familial HRs according to Cox proportional hazard model and ORs were obtained without any major differences. Apart from familial relationship, CAVB was associated with hypertension (OR, 1.83), diabetes (OR, 1.41), coronary heart disease (OR, 2.08), heart failure (OR, 5.01), and structural heart disease (OR, 4.59).
CONCLUSIONS
Risk of CAVB among relatives of affected individuals depends on relationship degree, being strongest in young siblings. The familial association extending to third-degree relatives indicates presence of genetic components in the cause of CAVB.
Topics: Male; Humans; Female; Sweden; Atrioventricular Block; Family; Siblings; Parents
PubMed: 36802810
DOI: 10.1161/CIRCGEN.121.003654 -
Tidsskrift For Den Norske Laegeforening... Nov 2019Periventricular nodular heterotopia (PNH) is an embryonal neuronal migration disturbance of the brain. The condition is rare and genetically heterogeneous, often caused...
BACKGROUND
Periventricular nodular heterotopia (PNH) is an embryonal neuronal migration disturbance of the brain. The condition is rare and genetically heterogeneous, often caused by mutations in the FLNA gene. The most common symptoms are epileptic seizures. PNH is often associated with other conditions such as cardiovascular abnormalities.
CASE PRESENTATION
A young man was admitted to hospital after a first episode of loss of consciousness. The patient was in normal general condition upon admission, and the clinical examination revealed no abnormalities. However, cerebral imaging performed upon admittance showed PNH, while an extended cardiac examination revealed atrioventricular block with the indication for a pacemaker. After pacemaker implantation and introduction of antiepileptic drug therapy, the patient has been free of symptoms.
INTERPRETATION
PNH is a condition that needs multidisciplinary assessments.
Topics: Adult; Atrioventricular Block; Electrocardiography; Humans; Male; Periventricular Nodular Heterotopia; Tomography, X-Ray Computed; Unconsciousness; Young Adult
PubMed: 31686471
DOI: 10.4045/tidsskr.19.0165 -
BMC Cardiovascular Disorders Nov 2023This article summarizes the treatment experience for congenital complete atrioventricular block (CCAVB) in newborns and infants, and discusses the necessity and...
BACKGROUND
This article summarizes the treatment experience for congenital complete atrioventricular block (CCAVB) in newborns and infants, and discusses the necessity and feasibility of treating CCAVB with permanent pacemaker implantation in this population.
METHODS
In this study, the clinical data and follow-up results of nine children admitted at our center with CCAVB from January 2005 to March 2023 were retrospectively analyzed. Among them, two children received early implantation of permanent pacemakers (within 1 year of age), two children received non-early implantation (1 year or older), and the remaining five children received no pacemaker implantation. CCAVB diagnosis was confirmed by clinical symptoms and clinical examinations, including electrocardiography and echocardiography before surgery. After surgery, the pacing and sensing functions of the pacemaker were observed using electrocardiography, echocardiography, and pacing threshold monitoring. A comprehensive assessment of the treatment efficacy was conducted, encompassing improvements in clinical symptoms, growth and development, as well as the absence of any additional potential complications. The children who did not receive pacemaker implantation were followed up.
RESULTS
Among the four children who successfully received pacemaker implantation, one child who received non-early implantation died. For the remaining three children, the threshold level, amplitude, impedance, and minute ventilation sensor function of the pacemaker were good during the follow-up period, with a heart rate at the pacing rate. The growth and development of the aforementioned patients who received pacemaker implantation demonstrated adherence to the percentile curve, and their motor and cognitive development remained unaffected. However, among the children who did not undergo pacemaker implantation, two experienced death, while three were lost to follow-up, thereby limiting the evaluation of their long-term outcomes.
CONCLUSIONS
Early implantation of an epicardial pacemaker at an early stage in newborns and infants diagnosed with CCAVB can significantly improve clinical symptoms without affecting their growth and development. These data are in line with current literature and suggest that early implantation of an epicardial pacemaker in newborns and infants diagnosed with CCAVB but further studies are needed.
Topics: Child; Humans; Infant; Infant, Newborn; Child, Preschool; Retrospective Studies; Atrioventricular Block; Cardiac Pacing, Artificial; Follow-Up Studies; Pacemaker, Artificial
PubMed: 37990158
DOI: 10.1186/s12872-023-03620-1 -
Journal of Cardiology Apr 2022Cardiovascular sequelae of coronavirus disease 2019 (COVID-19) infection have been explored by clinicians and researchers all over the world.
BACKGROUND
Cardiovascular sequelae of coronavirus disease 2019 (COVID-19) infection have been explored by clinicians and researchers all over the world.
OBJECTIVE
The purpose of this study was to evaluate the incidence of atrioventricular block (AV) in patients hospitalized for COVID-19 and its association between in-hospital morbidity and mortality.
METHODS
In-hospital electrocardiograms (ECGs) of 438 patients were compared with their prior or baseline ECGs to ascertain the development of new onset AV block. Patients who developed new AV blocks were then followed at 30 and 90 days post-discharge to check for resolution of AV block. Demographic characteristics, clinical characteristics, and complications during their hospital stay were evaluated. Major complications including respiratory failure requiring oxygen supplementation and mechanical ventilation, sepsis, deep vein thrombosis, elevated troponins, hospital and intensive care unit (ICU) length of stay, as well as death were compared between those who developed new onset AV blocks and those who did not.
RESULTS
Based on our single center study, the incidence of new onset AV blocks among patients admitted for COVID-19 during the study period was 5.5 cases per 100 patients. New onset AV blocks were not associated with longer hospital and ICU length of stay, increased intubation rates, or increased mortality.
CONCLUSION
Although the development of a new onset AV block is most likely multifactorial and not solely due to COVID-19, it is still important for clinicians to be mindful about the possibility of developing symptomatic bradycardia and life-threatening arrhythmias in patients admitted for COVID-19. This can be achieved by appropriate rhythm monitoring in-patient but the need for a cardiac event monitor upon discharge is unlikely to be necessary. Careful history taking, including family and drug use history is also of great importance as emerging drug therapies for COVID-19 have potential arrhythmogenic effects.
Topics: Aftercare; Atrioventricular Block; COVID-19; Hospital Mortality; Humans; Incidence; Patient Discharge; SARS-CoV-2
PubMed: 34848117
DOI: 10.1016/j.jjcc.2021.10.025 -
Kardiologia Polska 2021
Topics: Atrioventricular Block; COVID-19; Cardiac Pacing, Artificial; Humans; Pacemaker, Artificial; SARS-CoV-2
PubMed: 34599492
DOI: 10.33963/KP.a2021.0111 -
The Journal of International Medical... Jan 2024Atrioventricular block (AVB) is a rare cardiac manifestation of hyperthyroidism (HTH). The scientific literature contains multiple reports of AVB in patients with HTH,... (Review)
Review
Atrioventricular block (AVB) is a rare cardiac manifestation of hyperthyroidism (HTH). The scientific literature contains multiple reports of AVB in patients with HTH, ranging from subclinical to overt HTH and even thyroid storm. However, much remains unknown about the true prevalence, clinical course, optimal management, and outcomes of AVB in patients with HTH. Such patients are possibly overtreated with pacemakers because of a lack of understanding that AVB might be secondary to the hyperthyroid state and thus reversible. This narrative review discusses the pathophysiology of AVB in patients with HTH in the context of the available evidence.
Topics: Humans; Atrioventricular Block; Hyperthyroidism; Patients; Heart
PubMed: 38206211
DOI: 10.1177/03000605231223040 -
Journal of Comparative Pathology Feb 2023The cardiac conduction system was examined histologically in 13 canine cases of atrioventricular (AV) valve endocardiosis with third-degree AV block. In all cases, gross...
The cardiac conduction system was examined histologically in 13 canine cases of atrioventricular (AV) valve endocardiosis with third-degree AV block. In all cases, gross examination revealed marked thickening and distortion of the base of the central fibrous body (CFB) and varying degrees of endocardial thickening of the upper portion of the ventricular septum (VS) as well as marked thickening of the mitral and tricuspid valve leaflets due to myxomatous degeneration. Microscopically, the thickened and distorted CFB had encased or trapped, either partly or totally, the underlying penetrating and branching portions of the AV bundle. The myxomatous and/or fibrofatty tissue, which had proliferated at the base of the extensive CFB, protruded into or encroached on the AV bundle, causing severe (51-75%) to very severe (76% or more) reduction of the conduction fibres. The upper portions of the left and right bundle branches were involved in the endocardial thickening due to degenerative and fibrotic changes at the uppermost VS; however, both bundle branches were much less severely affected than the AV bundle, the degree of reduction of the conduction fibres ranging from mild (25% or less) to moderate (26-50%). These observations suggest that the sites most vulnerable to lesions in the AV conduction system are the penetrating and branching portions of the AV bundle, which would represent the anatomical basis for third-degree AV block in canine cases of AV valve endocardiosis.
Topics: Animals; Dogs; Atrioventricular Block; Bundle of His; Dog Diseases; Endocardium; Heart Conduction System; Heart Diseases
PubMed: 36709730
DOI: 10.1016/j.jcpa.2022.12.014 -
Pediatrics and Neonatology Dec 2008
Topics: Adolescent; Atrioventricular Block; Child; Child, Preschool; Female; Humans; Infant; Male; Myocarditis; Prognosis
PubMed: 19166116
DOI: 10.1016/S1875-9572(09)60012-7