Aggressive rhythm management with a temporary pacemaker can lead to favorable outcomes in pediatric acute fulminant myocarditis with complete heart block in resource-limited settings.
Supports consideration of temporary pacing in pediatric fulminant myocarditis with heart block; hypothesis-generating and requires prospective validation.
Complete heart block in paediatric acute fulminant myocarditis (AFM) is rare and carries a grave prognosis. Aggressive haemodynamic support, especially mechanical support, i.e. with an extracorporeal membrane oxygenator during the initial presentation, improves the outcome in such patients. Unavailability of mechanical support in developing countries warrants aggressive rhythm management to achieve haemodynamic stability. We report a case of a 5-month-old who presented with AFM complicated with complete heart block. Quick recognition, aggressive cardiopulmonary management and transcatheter placement of a temporary pacemaker as soon as possible resulted in complete recovery in this patient. Aggressive management with rhythm control can lead to a favourable outcome in paediatric patients with AFM complicated by complete heart block, even in a resource-limited set-up.
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Merchant et al. (2015) studied this question.
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