Key Points
- To assess 24-hour ventricular rate variations and secondary arrhythmias using ambulatory electrocardiographic monitoring in children with congenital complete heart block and structurally normal hearts.
- Conducted 24-hour ambulatory electrocardiographic monitoring in 18 pediatric patients (N=18) with congenital complete heart block and no cardiac structural anomalies.
- Categorized patients into three groups based on patterns of 24-hour beat-to-beat ventricular rate fluctuations and their correlation with atrial rates.
- Detected secondary arrhythmias in 12 of 18 patients, including sporadic ventricular premature contractions in 9 patients, as well as bigeminy or ventricular tachycardia during exercise in 2 patients.
- Identified sudden nocturnal RR interval prolongations in 3 patients with ventricular asystole durations of 7.2, 3.2, and 3.2 seconds due to exit block or subsidiary pacemaker arrest, with one patient experiencing frequent Stokes-Adams attacks.
Structured PICO
PPopulation18 children with congenital complete heart block (CCHB) and no cardiac structural anomalies.
IIntervention24-hour ambulatory electrocardiographic monitoring
OOutcomePattern of fluctuations in beat-to-beat ventricular rates and presence of additional arrhythmiassurrogate
24-hour ambulatory ECG monitoring in children with congenital complete heart block is useful for identifying high-risk arrhythmia patterns, such as sudden RR prolongation and ventricular arrhythmias, which may predispose to Stokes-Adams attacks.