Congenital Atrioventricular Block in an Adolescent Female: A Case Report

Zahri Soukaina *

Cardiology Department, UHC Ibn Rochd, Casablanca, Morocco.

Ghali Bennani

Cardiology Department, UHC Ibn Rochd, Casablanca, Morocco.

Lamiaa Tlohi

Cardiology Department, UHC Ibn Rochd, Casablanca, Morocco.

Samia Ejjebli

Cardiology Department, UHC Ibn Rochd, Casablanca, Morocco.

Imad Nouamou

Cardiology Department, UHC Ibn Rochd, Casablanca, Morocco.

Salim Arous

Cardiology Department, UHC Ibn Rochd, Casablanca, Morocco.

Abdennaser Drighil

Cardiology Department, UHC Ibn Rochd, Casablanca, Morocco.

Rachida Habbal

Cardiology Department, UHC Ibn Rochd, Casablanca, Morocco.

*Author to whom correspondence should be addressed.


Abstract

Introduction: Congenital atrioventricular block (CAVB) is a rare cardiac condition characterized by impaired electrical conduction between the atria and ventricles. We present a case report of an 18-year-old female patient with no significant medical history admitted to the cardiology department with complete atrioventricular block.

Case Presentation: The patient presented with a two-week history of syncope episodes without chest pain or other symptoms, alongside preserved general condition. Physical examination revealed bradycardia (40 bpm) and confirmed complete atrioventricular block on electrocardiogram. Transthoracic echocardiography showed preserved ejection fraction with no significant valvular disease. Laboratory investigations and serological tests were conducted to exclude underlying pathologies, with negative results. Subsequently, the patient underwent implantation of a double-chamber pacemaker.

Discussion: The case highlights the diagnostic challenges and management strategies associated with congenital atrioventricular block. While congenital and acquired causes should be considered, the absence of identifiable risk factors and negative serological markers suggested a congenital etiology in this case. Management typically involves pacemaker implantation to restore normal heart rhythm and prevent complications. Regular follow-up is essential for monitoring device function and detecting potential complications.

Conclusion: Congenital atrioventricular block is a rare but potentially serious condition that requires prompt diagnosis and management. Pacemaker implantation is the cornerstone of treatment to prevent complications and improve patient outcomes. Further research is needed to better understand the pathophysiology and optimize treatment strategies for this complex cardiac disorder.

Keywords: Cardiac arrhythmia, congenital atrioventricular block, pacemaker implantation


How to Cite

Soukaina, Zahri, Ghali Bennani, Lamiaa Tlohi, Samia Ejjebli, Imad Nouamou, Salim Arous, Abdennaser Drighil, and Rachida Habbal. 2024. “Congenital Atrioventricular Block in an Adolescent Female: A Case Report”. Asian Journal of Cardiology Research 7 (1):104-10. https://journalajcr.com/index.php/AJCR/article/view/207.


References

Epstein AE, DiMarco JP, Ellenbogen KA, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2013;61(3).

Baruteau AE, Pass RH, Thambo JB, et al. Congenital and childhood atrioventricular blocks: Pathophysiology and contemporary management. Eur J Pediatr. 2016;175(9): 1235-1248.

Jaeggi ET, Hornberger LK, Smallhorn JF, et al. Prenatal diagnosis of complete atrioventricular block associated with structural heart disease: Combined experience of two tertiary care centers and review of the literature. Ultrasound Obstet Gynecol. 2005;26(1):16-21.

Melim C, Pimenta J, Areias JC. Congenital atrioventricular heart block: From diagnosis to treatment. Servic¸o de Cardiologia Pediátrica do Centro Hospitalar de São João, Departamento de Ginecologia Obstetrícia e Pediatria da FMUP, Porto, Portugal; 24 February 2022.

Balmer C, Bauersfeld U. Do all children with congenital complete atrioventricular block require permanent pacing? Indian Pacing Electrophysiol J. 2003;3:178-83.

Baruteau AE, Fouchard S, Behaghel A, et al. Characteristics and long-term outcome of non-immune isolated atrioventricular block diagnosed in utero or early childhood: A multicentre study. Eur Heart J. 2012;33:622-9.

Jalal Z, Bordachar P, Labrousse L, Mondoly P, Ritter P, Thambo J.B. Pacing in the paediatric population: Indications, implantation strategies, evolution and new stimulation techniques. Archives of Cardiovascular Diseases Supplements. 2012;4:138-147.

Beaufort- Krol G, Schasfoort- Van Leeuwen MJ, Stienstra Y, et al. Longitudinal echocardiographic follow- up in children with congenital complete atrioventricular block. Pacing ClinElectrophysiol. 2007;30:1339- 43.

Thambo JB, Bordachar P, Garrigue S, et al. Detrimental ventricular remodelling in patients with congenital complete heart block and chronic right ventricular apical pacing. Circulation. 2004;110: 3766- 72.

Moak JP, Hasbani K, Ramwell C, et al. Dilated cardiomyopathy following right ventricular pacing for AV block in young patients: Resolution after upgrading to biventricular pacing systems. J Cardiovasc Electrophysiol. 2006;17:1068- 71.

Martin TA. Congenital heart block: Current thoughts on management, morphologic spectrum, and role of intervention. Cardiol Young. 2014;24 Suppl. 2:41-6.

Anderson RH, Wenick AC, Losekoot TG, et al. Congenitally complete heart block. Developmental aspects. Circulation. 1977;56:90-101.

Barra sn, providencia r, paiva l, nascimento j, marques al. A review on advanced atrioventricular block in young or middle‐aged adults. Pacing and Clinical Electrophysiology. 2012 nov;35(11):1395-405.