Arrhythmias & electrophysiology
Natural History of Nonsurgical Complete Atrioventricular Block in Children and Predictors of Pacemaker Implantation
Main finding · Predictors of subsequent PM implantation (>1 month after first presentation)Result — go to the resultHazard ratio 0.938 95% CI 0.894–0.983Authors' conclusion
Pediatric patients with CAVB showed an age-dependent decrease in heart rate, moderate LV dilation, and preserved LV function. The probability of subsequent PM implantation could be predicted by the heart rate profile at presentation, defining a low-risk group and allowing for individualized follow-up.
Study context
- Population
- Children with nonsurgical complete atrioventricular block (CAVB) (no structural heart disease), presenting 1977–2016mean age 4.05 years
- Participants
- 95 children
- Outcome
- Natural course and predictors of PM implantation (>1 month after first presentation)
Methodological detailsnationwide, Follow-up median 0.80 years (IQR: 0.02-6.82 years), pacemaker (PM) implantation according to available guidelines; serial 24-h Holter and echocardiograms reviewed
- Nationwide
- Follow-up median 0.80 years (IQR: 0.02-6.82 years)
- PM implantation according to available guidelines; serial 24-h Holter and echocardiograms reviewed
Main finding
As reported in the abstract
Hazard ratio
0.938
95% CI 0.894–0.983
P = 0.003
Per unit increase, as printed
- Freedom from PM within subsequent 5 years, mean 24-hour heart rate >58 beats/min vs others
- 91.7% vs 44.4%; P < 0.001
- PM implantation performed (reaching guideline criteria)
- 62 patients (65.3%)
Observational data: associations, not effects.
Further findings
Freedom from PM within subsequent 5 years
P < 0.001
24-h heart rates and maximum RR intervals vs age
- Minimum and mean 24-h HR and maximum RR intervals had a nonlinear correlation with age
- P < 0.0001 for all
Left ventricular (LV) size and shortening fraction · throughout follow-up
- LV size moderately increased; shortening fraction normal in the majority
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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