The Long-term Outcome of Children with Isolated Congenital Complete Atrioventricular Block

先天性完全房室傳導阻斷且心臟結構正常的病人可能轉為低度房室傳導阻斷，而不需要心律調整器治療，這種心律的改變於兒科病人較少被研究，本研究的目的是報告本院先天性完全房室傳導阻斷兒科病人的長期追蹤，並著重於探討竇性心律的回復。研究對象包含本院十六位先天性完全房室傳導阻斷且心臟結構正常的兒科病人，他們的醫療記錄被詳細檢閱整理，並分為產前組（共九位）和產後組（共七位）兩組。研究結果顯示產前組於追蹤28個月（中位數，範圍1至154個月），一位無症狀病人有短暫竇性心律的回復和不需要心律調整器治療，五位病人需要心律調整器治療且其中三位死亡，剩餘三位無症狀病人不需要心律調整器治療；產後組於追蹤84個月（中位數，範圍14至133個月），一位無症狀病人有竇性心律的回復和不需要心律調整器治療，三位病人需要心律調整器治療且存活下來，剩餘三位無症狀病人不需要心律調整器治療；和產後組相比後，產前組較早接受心律調整器治療和有較高比率的母體自體免疫疾病，至於兩組的性別、心律調整器治療比率、擴張性心肌病變、和死亡率，並沒有顯著的差異。研究結論是大多數先天性完全房室傳導阻斷且心臟結構正常的病人最終需要心律調整器治療，但是，一些兒科病人的心律可能轉為低度房室傳導阻斷，而不需要心律調整器治療。

關鍵字

先天性完全房室傳導阻斷；竇性心律的回復；擴張性心肌病變；心律調整器治療

並列摘要

Patients with isolated congenital complete atrioventricular block (CCAVB) may revert to a lower degree of atrioventricular block and do not require pacemaker treatment. The change of rhythm is less well studied in pediatric patients. The aim of this study was to report the long-term outcome of pediatric patients with isolated CCAVB at our institution, with emphasis on restoration of sinus rhythm. We reviewed the medical records of 16 consecutive children with isolated CCAVB at our institution. They were divided into a prenatal group (n=9) and a postnatal group (n=7). In the prenatal group, with follow-up of 28 months (median, range 1-154 months), one patient without symptoms had transient restoration of sinus rhythm and did not require pacemaker therapy, five patients required pacemaker therapy and three of them died, and the remaining three patients without symptoms did not require pacemaker therapy. In the postnatal group, with follow-up of 84 months (median, range 14-133 months), one patient without symptoms had restoration of sinus rhythm and did not require pacemaker therapy, three patients required pacemaker therapy and survived, and the remaining three patients without symptoms did not require pacemaker therapy. Compared to the postnatal group, the prenatal group needed earlier pacing and had higher rate of maternal autoantibodies. There were no significant differences in sex, pacemaker implantation rate, dilated cardiomyopathy, and mortality rate between the two groups. Pacemaker implantation is indicated in most patients with isolated CCAVB, but a change to a lower degree of block can occur in some pediatric patients who may not require pacemaker implantation.

並列關鍵字

congenital complete atrioventricular block ； restoration of sinus rhythm ； dilated cardiomyopathy ； pacemaker implantation

國際替代計量

The Long-term Outcome of Children with Isolated Congenital Complete Atrioventricular Block

全文下載

主題瀏覽