Twenty patients with congenital complete heart block (CHB) were monitored with ECG tape recordings while awake and asleep. Episodes of marked ventricular slowing during sleep (R-R greater than 3000 msec., i.e. less than 20 beats/min) were noted in 35% (7/20). Most of these sudden R-R prolongations were 2:1 or 3:1 exit block of the junctional focus. Atrial and ventricular rate changes were mostl...

Six children, aged between 3 and 19 years, with congenital complete heart block without associated cardiac disease were studied by His bundle electrography. All were symptomatic with resting ventricular rates over 40 beats/min, and electrocardiograms that showed a normal axis and QRS complex. His bundle to ventricular activation was within the normal range in all and the block was proximal to t...

A female neonate with congenital complete heart block developed atrioventricular conduction through an accessory pathway. Despite sinus rhythm and an adequate heart rate she developed severe dilated cardiomyopathy and died at age 14 months. This case illustrates that underlying heart block can be present in individuals with asymptomatic Wolff-Parkinson-White syndrome and that the dilated cardio...

The development of complete heart block is described in a patient with polymyositis. The implantation of a permanent pacemaker has controlled the heart block, but the progression of the underlying disease despite treatment with relatively high dosage of corticosteroids makes the outlook uncertain.

Atrioventricular block may occur in various acute and chronic diseases pertaining to the myocardium, or the structures surrounding, or in close proximity to the A-V node,' bundle and bundle branches. When atrio-ventricular conduction is disrupted the ventricles are activated by distal pacemakers. Complete heart block usually results in some degree of cardiac insufficiency, manifested as a reduc...

OBJECTIVES Cardiac depression is a well-described manifestation of the sepsis syndrome. An important underlying mechanism is the attenuation of the adrenergic response at the cardiomyocyte level. By reducing their cell-specific function (contractility), the cardiomyocytes reduce their energy expenditure. Consequently, the cardiac myocytes survive in a hibernation-like state as long as intracell...

Complete heart block is a conduction disorder characterized by a random relationship between the atrial and the ventricular activation where the atrial impulses are not conducted to the ventricle. The incidence of complete heart block (CHB) is estimated to be 1 in 15,000 to 20,000 live births [1]. It may be congenital or acquired. The acquired variety is rare during pregnancy as this type is mo...

A 26 years old male presented with vertigo and history of fall. The electrocardiogram revealed 2:1 second-degree heart block and later progression to complete heart block. Transthoracic echocardiography revealed aneurysm at the site of ascending aorta and computed tomographic scan showed an aneurysm of right sinsus of Valsalva extending into right atrioventricular and interventricular groove an...

The cause of chronic heart block is often obscure on clinical grounds alone. Consequently there is considerable difficulty in deciding the prognosis of a patient with complete heart block even with successful artificial pacing. Coronary artery disease has been generally accepted in the past as the predominant cause of heart block, and Penton, Miller, and Levine (1956) estimated an incidence of ...

High-degree heart block is an uncommon manifestation of acute myocarditis in adults. The rate of heart block requiring a pacemaker in biopsy-proven acute lymphocytic myocarditis generally is low but has been reported in up to 8.3% of cases.1 Important exceptions include cardiac sarcoidosis and giant cell myocarditis (GCM), 2 uncommon and idiopathic disorders for which early immunosuppression ma...