Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun;64(3):275-8.
doi: 10.7727/wimj.2013.199. Epub 2015 Mar 12.

Paroxysmal Complete Atrioventricular Block: A Rare Cause of Syncope in Children

H Olgun  1 , N Ceviz  2 , T Karagoz  3
Affiliations

Paroxysmal Complete Atrioventricular Block: A Rare Cause of Syncope in Children

H Olgun et al. West Indian Med J. 2015 Jun.

Abstract
in English, Spanish

Paroxysmal atrioventricular block (PAVB) is a rare cause of syncope, mostly reported in adults. In the present study, a child with recurrent syncope due to PAVB is reported. A 12-year old boy was admitted due to syncope. Some syncopal episodes were consistent with vasovagal syncope, while others had atypical features. Electrocardiography, echocardiography and 24-hour electrocardiography monitoring were normal. Head-up tilt table test revealed mixed type vasovagal syncope. With beta-blocker treatment, the frequency of syncopal episodes decreased; however, the episodes with atypical features continued. Intracardiac electrophysiological study was normal, but repeated external loop recorder monitoring revealed transient AVB during a syncopal episode. In children with syncope with atypical features, PAVB should be kept in mind. Repeated external loop recorder monitoring may be useful in the diagnosis of such seldom seen arrhythmic causes.

El bloqueo auriculoventricular paroxístico (BAVP) es una causa rara del síncope, reportada principalmente en adultos. El presente estudio, reporta el caso de un niño con síncope recurrente debido al BAVP. El niño, de 12 años de edad, fue ingresado a causa de un síncope. Algunos episodios sincopales correspondían a síncopes vasovagales, mientras que otros tenían características atípicas. La electrocardiografía, la ecocardiografía y 24 horas de monitoreo con electrocardiografía fueron normales. La prueba de inclinación con mesa basculante reveló un síncope vasovagal de tipo mixto. Con el tratamiento con bloqueadores beta, disminuyó la frecuencia de los episodios sincopales. Sin embargo, continuaron los episodios con características atípicas. El estudio electrofisiológico intracardíaco arrojó resultados normales, el monitoreo repetido con grabador de bucle externo, reveló un BAV transitorio durante un episodio sincopal. En niños con síncope con características atípicas, la posibilidad de un BAVP debe tenerse en cuenta. El monitoreo repetido con grabador de bucle externo puede ser útil en el diagnóstico de esas causas arrítmicas raras veces vistas.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1. The electrocardiogram recorded during a syncope revealed two short complete atrioventricular block attacks (a).
Fig. 2
Fig. 2. 3:1 (b) and 2:1 (c) [in Fig.1] atrioventricular block periods followed the complete atrioventricular block attack (a).
See this image and copyright information in PMC

References

    1. Silver ES, Pass RH, Hordof AJ, Liberman L. Paroxysmal AV block in children with normal cardiac anatomy as a cause of syncope. Pacing Clin Electrophysiol. 2008;31:322–326. - PubMed
    1. The Task Force on Syncope, European Society of Cardiology Guidelines on management (diagnosis and treatment) of syncope—update 2004. Europace. 2004;6:467–537. - PubMed
    1. Castellanos A, Moleiro F, Acosta H, Ferreira A, Cox MM, Interian A, Jr, et al. Sudden Wenckebach periods and their relationship to neurocardiogenic syncope. PACE. 1998;21:1580–1588. - PubMed
    1. Silvetti MS, Grutter G, Di Ciommo V, Drago F. Paroxysmal atrioventricular block in young patients. Pediatr Cardiol. 2004;25:506–612. - PubMed
    1. Merghani A, Sharma S. Identifying patients at risk of sudden arrhythmic death. Practitioner. 2012;256:15–18. - PubMed

LinkOut - more resources