Why the study?
Few case series of transient fetal atrioventricular block have been reported, and a defined management approach has not been established.
Transient second-degree fetal AVB can be a benign, self-resolving phenomenon in the immature conduction system, requiring a specific management approach to avoid unnecessary interventions.
Suggests possible reversibility of fetal third-degree AVB; hypothesis-generating and should not yet change practice.
Fetal atrioventricular block (AVB) is a failure of conduction from atria to ventricles. Immune- and non-immune-mediated forms occur, especially in association with congenital heart disease. Second-degree (2°) AVB may be reversible with dexamethasone and IVIG in immune-mediated disease. However, once third-degree AVB develops, it is deemed irreversible with need for a pacemaker and risk for cardiomyopathy. Rarely, 2° AVB is a transient, benign phenomenon in the immature conduction system. Few case series of transient AVB have been reported, but a management approach has not been defined. We report four patients with self-resolving, non-immune fetal AVB and outline a management strategy.
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Kikano et al. (2022) studied this question.
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