Cortés-Ramírez JM, Cortés-de la Torre JMJ, Cortés-de la Torre RA, Reyes-Méndez BJ, Salazar-de Santiago A, Carrillo-Aguilar SI, Macías-Islas LC, Torres-Hernández JA, Zamora-Mejía FM

Language: Spanish
References: 12
Page: 625-627
PDF size: 541.00 Kb.

ABSTRACT

The atrioventricular block is a delay or interruption of the electrical impulse from the sinusal node, to level of the auricle-ventricular nodule. This is a congenital disease affecting 1 of every 20,000-25,000 born alive. It is secondary to an abnormal embryonic development of the node AV, and proximal branches of the bundle of His, associated with structural cardiac abnormalities or without structural malformations, for maternal isoimmunization with antibodies that cause immunological irreversible damage in the fetal heart tissue, by inflammation and subsequent fibrosis. Detected by fetal Doppler or echocardiography, between 16 and 30 weeks of gestation for persistent fetal bradycardia, with congestive heart failure or fetal dropsy with mortality of 20%. Factors of worst prognosis are: Coexistence with cardiovascular malformations, heart failure, ventricular frequency below 50 per minute during sleep, bradycardia less than 30 per minute, pacemaker under or changing and long QT. Medical treatment or pacemaker in newborns and breastfed infants is indicated with cardiac insufficiency and ventricular frequency below 50 per minute. In children and asymptomatic teenagers, follow-up with monitoring and echocardiography is recommended. Because our patient did not have them, we decided only to follow him with monthly echocardiogram and Holter every six months, unless there were data of low cardiac output.

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