Scary Pauses in Congenital AV Block
Report:
Sinus arrhythmia
Third degree AV block
Junctional escape rhythm
Comment:
Most patients with (idiopathic) congenital heart block have a reasonably fast junctional pacemaker and can get by without pacing. Presence of prolonged pauses may be an indication for pacing an asymptomatic patient. What constitutes a prolonged pause is a moot point; I would agree with 3 seconds18. Much depends on the overall heart rate, too; rates below 40/min are probably unacceptable.
This patient was paced. Perhaps a “prolonged pause” should be defined as one that scares the doctor looking at it!
If you have any suggestions for or feedback on this report, please let us know.
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