Permanent Pacemaker Treatment Of Congenital Third Degree Atrioventricular Block With Cardiac Arrest:A Case Report

Third degree atrioventricular block(III°AVB),also known as complete atrioventricular block(CAVB),is caused by an abnormal decrease in conduction capacity in a part of the atrioventricular conduction system.As a result,all atrial impulses cannot be transmitted down to the ventricle,causing separation of the atria.The electrocardiogram mainly manifests as complete atrioventricular separation,and the atrial rate is significantly faster than the ventricular rate.Third-degree atrioventricular block can be divided into congenital and acquired.The cause of congenital third degree atrioventricular block can be divided into cardiac structural abnormalities,immune system diseases and unexplained conduction block.Acquired third-degree atrioventricular block can be divided into acute and chronic,Acute third degree atrioventricular block is more common in the course of acute coronary syndrome(ACS).,after the application of certain drugs,cardiac surgery or injury caused by interventional surgery;and chronic third-degree atrioventricular block is common in a variety of reasons Ubiquitous myocardial scarring,such as dilated cardiomyopathy(DCM),ischemic cardiomyopathy,hypertension,and degeneration of the primary conduction system(Lenegre-lev disease).Congenital atrioventricular block is usually faster(50-80 beats / min),and the third-degree atrioventricular block ventricular rate is very slow(30-45 beats / min).Congenital third-degree atrioventricular block performance varies at different ages,some of which are non-specific symptoms such as poor physical growth,fatigue,sleep disturbances,and nightmares.Syncope,heart failure,or sudden death may be the first symptoms of congenital third degree atrioventricular block.Congenital third degree atrioventricular block fetus can have fetal heart failure,intrauterine fetal death.Congestive heart failure can occur in infancy and there can be no growth and developmental disorders within 5-10 years after infancy.Physical examination Bradycardia is the main sign,heart rate 50-80 beats/min,can change with different physiological conditions.Complications may include Adams-Stokes syndrome(A-S),syncope,cardiac arrest,heart failure,shock,and cerebral embolism.Treatment mayinclude medications(such as isoproterenol,atropine,hormones,immunoglobulins,or immunosuppressants,etc.)and cardiac pacing.The implantation of a pacemaker(Pacemaker,PM)is currently the most effective and reliable method,which can significantly reduce the patient’s mortality rate.For patients with ventricular tachycardia or Ventricular Fibrillation(VF),electrical defibrillation should be given immediately or by Implantable Cardioverter Defibrillator(ICD).