title: Long-Term Follow-Up of Children with Heart Block Born from Mothers with Systemic Lupus Erythematosus: A Retrospective Study from the Database Pediatric and Congenital Heart Disease in University Hospitals Leuven.
abstract: BACKGROUND
  Children from mothers with systemic lupus erythematosus are frequently born with congenital heart block. This study aimed at evaluating long-term outcome because long-term data are scarce.
  
  
  METHODS
  In the database of pediatric and congenital heart disease (University Hospitals Leuven), 19 children from systemic lupus erythematosus mothers and who were born with or developed atrioventricular block were identified. All records were reviewed for disease course and outcome.
  
  
  RESULTS
  Median follow-up time was 7 years (interquartile ranges [IQR] 4.5-13 years). One child had no heart block at birth and developed only a first-degree block during follow-up. One had a second-degree heart block and developed a complete heart block. Seventeen patients (89%) were born with a complete heart block. Seventeen patients (89%) needed a definitive pacemaker. In all, epicardial leads were used at first implantation. Eighty-two percent received their pacemaker in the first year of life. The first battery had a median lifetime of 5 years (IQR 3.5-5 years), the second 6 years (IQR 4.5-6.3 years), and the third 5 years (IQR 5-6 years). Note that 47% of patients needed a lead replacement due to lead problems. Only one pericardial tamponade after pacemaker implantation. No device or lead infections occurred. The left ventricular systolic function at latest follow-up was normal for all. No patients died.
  
  
  CONCLUSIONS
  In children with heart block born from systemic lupus erythematosus mothers, an early need for pacemaker implantation was documented. The overall battery life was acceptable, but there was a high need for lead replacement. Complication rate was low. Late outcome was good.
authors.affiliation: Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Eva
authors.initials: E
authors.lastname: DE Caluwé
authors.affiliation: Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Alexander
authors.initials: A
authors.lastname: VAN DE Bruaene
authors.affiliation: Department of Electrophysiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Rik
authors.initials: R
authors.lastname: Willems
authors.affiliation: Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Troost
authors.affiliation: Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Gewillig
authors.affiliation: Cardiothoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: Rega
authors.affiliation: Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium. werner.budts@uzleuven.be.
authors.forename: Werner
authors.initials: W
authors.lastname: Budts
mesh_terms: D000293:Adolescent; D001530:Belgium; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000151:congenital* / Q000453:epidemiology / Q000517:prevention & control; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: congenital heart block; epicardial; neonatal lupus; pacemaker