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Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Paroxysmal complete atrioventricular block in pregnant woman



Introduction. Diagnosis and treatment of arrhythmias in pregnant women is the uneasy challenge for clinicians. For pregnancy tachyarrhytmias, due to cardiovascular system overload and increase in sympathetic nervous system tone, are characteristic, whereas cardiac conduction disorders (AVB-atrioventricular blocks) are not related to pregnancy specifically so the treatment must be very carefully considered.Case report. 21 years old woman, 22 hbd, referred to clinic for diagnosis and treatment of heart palpitations. In ad-mission to hospital no aberration in physical status were observed, in echocardiography heart morphology and function were normal. During 14-days lasting ECG recording more than 100 AVB episodes were registered, mainly AVB II degree type 2, recurring advanced AVB II and complete AVB III. During these disturbances many pauses longer than 2 sec. were observed, several longer than 3 sec, the longest one reached 5,01 sec and appeared at 7.08 AM in 13th day of ECG monitoring. QRS complexes were narrow during the whole ECG registration. Because of lack of AVB clinical manifestations, possible qualification for heart pacemaker implantation was postponed to period after pregnancy. Delivery took place in 37 hbd, the child was healthy. 18 months after delivery the patient was hospitalised in order to proceed diagnosis and treatment of arrhythimas. In Holter- ECG only several episodes of AVB type 1 were observed with pauses < 2 sec and result of invasive electrophysiological testing was normal, without any disturbances in atrioventricular conduction. Conclusion. It is safe to postpone to the date after delivery the invasive diagnosis and therapy in pregnant woman with paroxysmal complete atrioventricular block on condition of regular visits and examinations performed by cardiologist.