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Brucato, A; Jonzon, A; Friedman, D; Allan, LD; Vignati, G; Gasparini, M; Stein, JI; Montella, S; Michaelsson, M; Buyon, J.
Proposal for a new definition of congenital complete atrioventricular block.
Lupus. 2003; 12(6):427-435 Doi: 10.1191/0961203303lu408oa
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Co-authors Med Uni Graz
Stein Joerg-Ingolf
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Abstract:
The classic old definition of congenital heart block by Yater (1929) is still generally accepted: 'Heart block established in a young patient. There must be some evidence of the existence of the slow pulse at a fairly early age and absence of a history of any infection which might cause the condition after birth: notably diphtheria, rheumatic fever, chorea and congenital syphilis'. However, other definitions are used. We systematically reviewed 1825 cases from 38 separate studies. We conclude that complete AV blocks detected in utero in the absence of structural abnormalities differ from blocks detected later in life with respect to pathogenesis (they are generally associated with maternal anti-Ro/SSA antibodies), poorer childhood prognosis, increased risk of developing late-onset dilated cardiomyopathy, different maternal clinical features and increased risk of recurrence in future pregnancies. For these reasons we propose a new modern definition of congenital complete AV block which might be acceptable to cardiologists, rheumatologists, pediatricians and obstetricians: 'an AV block is defined as congenital if it is diagnosed in utero, at birth or within the neonatal period (0-27 days after birth)'.
Find related publications in this database (using NLM MeSH Indexing)
Autoantibodies - adverse effects
Cardiomyopathy, Dilated - physiopathology
Female - physiopathology
Fetal Diseases - ultrasonography
Heart Block - classification
Humans - classification
Infant, Newborn - classification
Pregnancy - classification
Prognosis - classification
Risk Assessment - classification
Ultrasonography, Prenatal - classification

Find related publications in this database (Keywords)
congenital atrioventricular block
fetal heart block
heart block
congenital(MeSH term)
neonatal lupus
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