2000, Number 2
Placement of a definite epicardial pacemaker in a newborn with completa a-v block.
Siller RJ, Villegas CO, Martínez SR
Language: Spanish
References: 10
Page: 180-186
PDF size: 643.38 Kb.
ABSTRACT
Isolated congenital atrioventricular block is reported in one out of 20,000 live births. The optimistic view on the prognosis and indications for permanent pacing have been modified in the last 35 years. The purpose of this report is to present a prenataly diagnosed case, outlining the surgical technique for permanent pacing. The infant was a male born by cesarean section, weighted 3030 grs and had a structurally normal heart. His ECG showed complete AV block with narrow QRS, atrial rate was 140 and ventricular rate was 55. We implanted a epicardial pacemaker VVIR by midline laparatomy. The lead was unipolar 35 cms long screw-in type and was placed in the right ventricle through the xyphoid process. The pacemaker was placed in a GoreTex bag and fixed intraperitoneal to the abdominal wall. The infant did well after the procedure and he was discharged in good condition one week later. We conclude that it is appropriate to implant a permanent pacemaker in these patients with low ventricular rate thus reducing the risk of sudden cardiac death. The surgical technique is safe and makes easy the generator replacement.REFERENCES
Derlsen RH, Meilof JF: Anti-Ro/SS-A and anti-La/SS-B autoantibody levels in relation to systemic lupus eritematosus disease activity and congenital heart block. A longitudinal study comprising two consecutive pregnancies in a patient with systemic lupus eritematosus. Arthritis Reum 1992; 35: 953-959.