A 1-year-old boy with long pauses caused by paroxysmal atrioventricular block and sinus arrest: Vagal reflex and effect of pacing

作者：Sakazaki Sayaka; Masutani Satoshi^*; Evamoto Yoichi; Asano Yoshitaka; Miyamoto Ai; Ishido Hirotaka; Tamura Masanori; Senzaki Hideaki

来源：Journal of Electrocardiology, 2017, 50(2): 203-206.

DOI：10.1016/j.jelectrocard.2016.10.005

• Pacemaker
• Heart rate variability
• Vasovagal
• Bradycardia
• Parasympathetic
• Wavelet analysis

Paroxysmal atrioventricular block (PAVB) is rare in children. A 1-year-old boy presented with PAVE and sinus arrest that resulted in refractory life-threatening symptomatic long pauses. Continuous heart rate variability analysis with high time resolution (wavelet analysis) revealed an abrupt increase in parasympathetic activity just before a long pause, which indicated a vagal reflex. Although a pacemaker is not always effective because of a concomitant vasodepressive response in such cases, the complete stabilization after pacemaker implantation in this case supports the necessity and usefulness of pacemaker implantation in patients with reflex-induced highly symptomatic bradycardia.

• 出版日期2017-4