A 1-year-old boy with long pauses caused by paroxysmal atrioventricular block and sinus arrest: Vagal reflex and effect of pacing.
Paroxysmal atrioventricular block (PAVB) is rare in children. A 1-year-old boy presented with PAVB and sinus arrest that resulted in refractory life-threatening symptomatic long pauses. Continuous heart rate variability analysis with high time resolution (wavelet analysis) revealed an abrupt increase in parasympathetic activity just before a long pause, which indicated a vagal reflex. Although a pacemaker is not always effective because of a concomitant vasodepressive response in such cases, the complete stabilization after pacemaker implantation in this case supports the necessity and usefulness of pacemaker implantation in patients with reflex-induced highly symptomatic bradycardia.
Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Sayaka
S
Sakazaki
Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan. Electronic address: masutani@saitama-med.ac.jp.
Satoshi
S
Masutani
Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Yoichi
Y
Iwamoto
Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Yoshitaka
Y
Asano
Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Ai
A
Miyamoto
Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Hirotaka
H
Ishido
Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Masanori
M
Tamura
Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Hideaki
H
Senzaki
D054537:Atrioventricular Block / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D054138:Sinus Arrest, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D016896:Treatment Outcome
Bradycardia; Heart rate variability; Pacemaker; Parasympathetic; Vasovagal; Wavelet analysis