Non-invasive transcutaneous pacing is a safe and effective bridge to recovery for children with fulminant myocarditis and severe AV block when ECMO is unavailable.
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Urgent management of III° AV block in fulminant myocarditis may avert fatality; leaves open optimal protocols pending prospective data.
Fulminant myocarditis is a life-threatening clinical condition. It is the inflammation of myocardium leading to acute heart failure, cardiogenic shock and cardiac arrhythmias. Incidence of fulminant myocarditis is low and mortality is high. Most grievous complications of fulminant myocarditis is mainly cardiac arrhythmias; if there is delay on active management of the patient, it may be fatal. Here, we describe a case of III° atrioventricular block due to fulminant myocarditis that was managed with non-invasive transcutaneous cardiac pacing in the absence of ECMO. The non-invasive transcutaneous pacemaker is a safe, effective and convenient device to revert arrhythmias.
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Devkota et al. (2018) studied this question.
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