Temporary epicardial pacing in an extremely low-birth-weight infant with congenital atrioventricular block.
Congenital atrioventricular block is a rare, but severe occurrence in the newborn can be related to various cardiac malformations or to maternal autoimmune diseases, particularly systemic lupus erythematosus. We report an extremely low-birth-weight infant affected by congenital heart block, due to positive anti-RO/SSA and anti-LA/SSB antibodies of the mother, with progressively increasing respiratory distress syndrome and heart failure. The infant was successfully treated with an external constant-current, single-chamber ventricular (VVI) temporary epicardial pacing, placed on the second day of life, at the weight of 810 g. After this treatment, cardiac failure resolved and respiratory assistance could be rapidly stopped. A single-chamber, rate-responsive, permanent pacemaker was placed at 3 months of life with steroid-eluting, epicardial-pacing leads. We emphasize that early extrathoracic temporary epicardial pacing is able to resolve heart failure in an extremely low-birth-weight infant.
Filippi
Luca
L
Neonatal Intensive Care Unit, Department of Critical Care Medicine, Meyer University Hospital, Florence, Italy. filippi.luca@virgilio.it
Vangi
Venturella
V
Murzi
Bruno
B
Moschetti
Riccardo
R
Colella
Andrea
A
D000974:Antibodies, Antinuclear / Q000097:blood; D054537:Atrioventricular Block / Q000151:congenital* / Q000503:physiopathology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000209:etiology; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D010496:Pericardium / Q000503:physiopathology*; D011247:Pregnancy / Q000276:immunology; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000209:etiology / Q000628:therapy; D013997:Time Factors
D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; C035357:SS-B antibodies