Trifascicular block with intermittent complete atrioventricular block in a child.
Trifascicular block, which consists of impaired conduction in the three main fascicles of the ventricular conduction system, may progress to high-grade or complete atrioventricular block. It rarely occurs in children with a structurally normal heart. We report a case of trifascicular block in a previously healthy 9-year-old girl. The patient presented with repetitive seizures. The electrocardiogram showed a complete right bundle branch block, left axis deviation, PR interval prolongation, and intermittent high-degree and complete atrioventricular block. She was successfully treated with a temporary pacemaker and her electrocardiogram returned to a normal sinus rhythm in 3 days. She has remained well over a 4-year follow-up. Although her cardiac enzyme levels were normal, the clinical course and electrocardiography findings suggested myocarditis. We emphasize the diagnosis of trifascicular block using electrocardiography; clinical outcome is good, if the patient is managed properly.
Wu
J M
JM
Department of Pediatrics, National Cheng-Kung University Hospital, Tainan, Taiwan, ROC.
Wang
J N
JN
Lin
C S
CS
Lee
W L
WL
D002648:Child; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans