Optimal pacing in congenital complete atrioventricular block of immunological origin: interest of multisite stimulation.
An infant with a congenital auriculoventricular block (CAVB) of immunological origin was diagnosed prenatally. The mother had Gougerot-Sjögren disease with positive anti-Sjogren's Syndrome A (SSA) and Sjogren's Syndrome B (SSB) serologies. Cardiac pacing was necessary and the epicardial route was chosen. Considering the left ventricular (LV) dilatation, bi-ventricular (BiV) stimulation was preferred to the usual DDD mode, presumed to have a deleterious long-term effect. Echographic parameters were better with BiV stimulation: the asynchronism induced by mono-RV stimulation was corrected and the QRS complexes were narrower. BiV pacing of a CAVB with LV dilation looks clinically and echographically attractive but needs to be validated in the long term.
Rumeau
P
P
Rhythmology and Cardiac Pacing, Cardiology Federation, Toulouse University Hospital, Toulouse, France. rumeauphil@yahoo.fr
Dulac
Y
Y
Coulier
H
H
Duparc
A
A
Leobon
B
B
Acar
P
P
Roux
D
D
Delay
M
M
D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D006327:Heart Block / Q000151:congenital* / Q000276:immunology / Q000503:physiopathology*; D006330:Heart Defects, Congenital / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012859:Sjogren's Syndrome / Q000276:immunology