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Outcome of children with fetal, neonatal or childhood diagnosis of isolated congenital atrioventricular block

A single institution’s experience of 30 years

Edgar T. Jaeggi, MD^*, Robert M. Hamilton, MD^*, Earl D. Silverman, MD, Samuel A. Zamora, MD and Lisa K. Hornberger, MD^*,*

^* Division of Cardiology, The Hospital for Sick Children, University of Toronto, Canada and
Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Canada
Division of Pediatric Cardiology, University Children’s Hospital, Geneva, Switzerland

View larger version (48K): [in a new window]   Figure 1 Number of new cases diagnosed with isolated complete heart block during different time periods.

View larger version (18K): [in a new window]   Figure 2 Kaplan-Meier survival of CAVB diagnosed during the fetal, neonatal and childhood periods differed significantly between the groups (log-rank; 2 = 17.2, p = 0.0002). Further analyses using log-rank tests with Bonferroni corrections confirmed the reduced survival rate of the fetal cases (fetal vs. neonatal: 2 = 6.04, p = 0.03; fetal vs. childhood: 2 = 12.3, p = 0.001).

View larger version (17K): [in a new window]   Figure 3 Kaplan-Meier freedom of pacemaker implantation comparing fetal, neonatal and childhood diagnosis of CAVB. Global differences between the groups (log-rank; 2 = 28.4, p < 0.001) were further analyzed using log-rank tests and Bonferroni corrections. Time of implantation differed significantly between the childhood group and the neonatal group (2 = 7.8, p = 0.02) and between the childhood group and the fetal group (2 = 33.9, p < 0.001) but not between the neonatal and fetal groups (2 = 4.4, p = 0.09) after adjustment for multiple comparison.