Pregnancy and congenital complete atrioventricular block: management during pregnancy and periparturient period (RCD code: VII-V)

Abstract

Complete atrioventricular block (AVB) is rare during pregnancy. Congenital atrioventricular block is the most common type of heart block in this group of patients. About one‑third of female patients with complete AVB remain asymptomatic until adulthood and may be first diagnosed during pregnancy. We present a case of a 31‑year‑old pregnant woman with complete AVB who was in her final stage of pregnancy. After reviewing the various advantages and disadvantages of feasible approaches with the patient, we decided to use fluoroscopy‑guided temporary backup pacemaker implantation. Estimated radiation skin dose was small and safe. The patient agreed to this treatment plan. Four days prior to scheduled cesarean delivery (39 weeks of gestation), during a one‑day stay in the hospital, the patient underwent single‑chamber temporary pacemaker implantation (using transvenous active fixation lead and external re‑sterilized pacemaker). The abdominal and pelvic regions were covered with a lead shield. The caesarean delivery was uneventful and the baby was healthy with an Apgar score of 10. JRCD 2017; 3 (6): 205–209.