Blok serca
Epidemiologia

Blok przedsionkowo-komorowy (AV) jest powszechnym zaburzeniem przewodzenia elektrycznego serca, którego częstość występowania wzrasta wraz z wiekiem, szczególnie u osób powyżej 65. roku życia, oraz w obecności chorób układu sercowo-naczyniowego, takich jak cukrzyca (1,1%) i nadciśnienie tętnicze (0,6%). Epidemiologia bloków AV różni się w zależności od typu: blok pierwszego stopnia występuje u 6,84 na 100 osób, blok drugiego stopnia u 0,18 na 100 osób, a blok trzeciego stopnia (całkowity) u 0,04 na 100 osób (dane z Chin). W populacji USA blok trzeciego stopnia występuje u 0,02-0,04%, a blok drugiego stopnia u 3 na 100 000 osób. Wrodzony blok serca jest rzadki (1 na 15 000-22 000 urodzeń), często związany z obecnością przeciwciał anty-Ro/SSA i/lub anty-La/SSB u matki, i charakteryzuje się wysoką śmiertelnością (~20%). Istotny jest komponent rodzinny, zwłaszcza w przypadkach wczesnego początku bloku AV, gdzie ryzyko u krewnych pierwszego stopnia jest ponad dwukrotnie wyższe, a u potomstwa rodziców z rozrusznikiem przed 50. rokiem życia nawet 10-krotnie wyższe.

  1. Epidemiologia bloku serca
    1. Częstotliwość występowania różnych typów bloku serca
    2. Czynniki ryzyka i wzorce demograficzne
    3. Blok serca a choroby współistniejące
  2. Blok serca wrodzony
    1. Blok serca związany z przeciwciałami matek
    2. Wskaźniki umieralności i chorobowości
  3. Nadzór i monitorowanie bloku serca
    1. Badania przesiewowe u kobiet w ciąży
    2. Domowe monitorowanie tętna płodu
    3. Specyficzne grupy ryzyka wymagające nadzoru
  4. Trendy epidemiologiczne i czynniki ryzyka
  5. Inicjatywy badawcze i przyszłe kierunki
  6. Implikacje zdrowia publicznego
  7. Podsumowanie epidemiologii bloku serca
    1. Kolejne rozdziały

Epidemiologia bloku serca

Blok serca (blok przedsionkowo-komorowy, AV) jest stosunkowo częstym zaburzeniem przewodzenia elektrycznego w sercu, jednak jego dokładna częstość występowania nie została w pełni określona ze względu na brak obszernych badań populacyjnych skupiających się konkretnie na tym schorzeniu1. Dane epidemiologiczne różnią się w zależności od typu bloku, wieku pacjenta, współistniejących chorób oraz regionu geograficznego.

Częstotliwość występowania różnych typów bloku serca

Badanie przeprowadzone w Chinach na 15 milionach uczestników wykazało, że standaryzowana według wieku i płci częstość występowania wszystkich typów bloku AV wynosiła 7,06 na 100 osób (95% CI: 7,01-7,11). W rozbiciu na poszczególne typy bloku AV częstość występowania wynosiła1:

  • Blok pierwszego stopnia: 6,84 na 100 osób (95% CI: 6,79-6,89)
  • Blok drugiego stopnia: 0,18 na 100 osób (95% CI: 0,17-0,18)
  • Blok trzeciego stopnia (całkowity): 0,04 na 100 osób (95% CI: 0,03-0,04)

W populacji ogólnej Stanów Zjednoczonych częstość występowania bloku AV trzeciego stopnia (całkowitego) szacuje się na około 0,02-0,04%12. Natomiast w przypadku bloku drugiego stopnia szacuje się częstość występowania na poziomie 3 na 100 000 osób1.

Czynniki ryzyka i wzorce demograficzne

Częstość występowania bloku AV jest ściśle związana z wiekiem i znacząco wzrasta u osób powyżej 65. roku życia, szczególnie w wyniku degeneracji tkanki przewodzącej serca12. Występowanie bloku AV pierwszego stopnia zwiększa się z wiekiem według następującego wzorca1:

  • W wieku 20 lat: odstęp PR przekraczający 0,20 sekundy występuje u 0,5-2% zdrowych osób
  • W wieku 60 lat: ponad 5% zdrowych osób ma odstęp PR przekraczający 0,20 sekundy

Dane wskazują, że blok przedsionkowo-komorowy pierwszego stopnia może występować częściej u pacjentów pochodzenia afroamerykańskiego niż kaukaskiego we wszystkich grupach wiekowych, z wyjątkiem ósmej dekady życia1. W przypadku całkowitego bloku serca (trzeciego stopnia) nie stwierdzono wyraźnej predyspozycji rasowej2.

Badania sugerują również, że blok AV może mieć komponent rodzinny. W badaniu obejmującym 4 648 204 osób wykazano, że krewni pierwszego stopnia pacjentów z blokiem AV mają ponad dwukrotnie większe ryzyko rozwoju bloku AV w porównaniu z populacją ogólną. Ryzyko to było odwrotnie proporcjonalne do wieku, w którym u krewnego zdiagnozowano blok AV i wymagano wszczepienia rozrusznika1.

Blok serca a choroby współistniejące

Częstość występowania bloku AV zwiększa się znacząco u pacjentów z chorobami układu sercowo-naczyniowego. Badanie przeprowadzone w systemie opieki zdrowotnej Veterans Health Administration wykazało, że częstość występowania bloku serca trzeciego stopnia wynosiła12:

  • 1,1% u pacjentów z cukrzycą
  • 0,6% u pacjentów z nadciśnieniem tętniczym

Bloki serca mogą również występować w powiązaniu z innymi schorzeniami kardiologicznymi, takimi jak1:

  • Migotanie przedsionków
  • Kardiomiopatie
  • Strukturalne choroby serca

Badanie z 2019 roku sugeruje, że dwa kluczowe czynniki ryzyka sercowo-naczyniowego – wysokie ciśnienie krwi i podwyższony poziom glukozy we krwi – są powiązane z większym ryzykiem rozwoju bloku serca1.

Blok serca wrodzony

Wrodzony blok serca jest rzadkim zaburzeniem, występującym w około 1 na 15 000-22 000 żywych urodzeń12. W większości przypadków (ponad 90%) jest związany z chorobami autoimmunologicznymi matki i transferem przeciwciał matczynych1.

Blok serca związany z przeciwciałami matek

Wrodzony blok serca często wiąże się z obecnością przeciwciał anty-Ro/SSA i/lub anty-La/SSB u matki1. Częstość występowania wrodzonego bloku serca u kobiet w ciąży z przeciwciałami anty-Ro/SSA wynosi około 2%123. U dzieci matek z przeciwciałami anty-Ro/SSA blok przedsionkowo-komorowy może rozwinąć się w drugim trymestrze ciąży (najczęściej między 18 a 26 tygodniem)1.

Częstość nawrotów bloku serca u kolejnych dzieci tych samych matek wynosi około 16-18%1. Istnieje też 60% przewaga występowania wrodzonego bloku serca trzeciego stopnia u płci żeńskiej, podczas gdy nabyte bloki trzeciego stopnia występują częściej (60%) u mężczyzn1.

Wskaźniki umieralności i chorobowości

Wrodzony blok serca wiąże się z wysoką zachorowalnością i śmiertelnością. Ogólna śmiertelność związana z wrodzonym blokiem serca wynosi około 20%1. W dużym rejestrze w USA prawdopodobieństwo zgonu wynosiło 17,5%, przy czym jedna trzecia tych płodów zmarła wewnątrzmacicznie1.

Większość zgonów związanych z wrodzonym blokiem serca następuje w okresie płodowym lub w pierwszych 3 miesiącach po urodzeniu1. U dzieci z blokiem serca związanym z przeciwciałami matki istnieje 80% prawdopodobieństwo przeżycia w wieku 3 lat1.

Około 60-70% pacjentów z wrodzonym blokiem serca będzie wymagało wszczepienia rozrusznika serca, niezależnie od wieku, w którym postawiono diagnozę1.

Nadzór i monitorowanie bloku serca

Badania przesiewowe u kobiet w ciąży

Ze względu na ryzyko rozwoju bloku serca u płodów matek z przeciwciałami anty-Ro/SSA i anty-La/SSB, opracowano różne strategie nadzoru i monitorowania1. American College of Rheumatology zaleca seryjne (rzadziej niż cotygodniowe) badania echokardiograficzne płodu, rozpoczynające się między 16-18 tygodniem ciąży i kontynuowane do 26 tygodnia u kobiet w ciąży z przeciwciałami anty-Ro/SSA i/lub anty-La/SSB, ale bez historii wrodzonego bloku serca u poprzednich dzieci1.

Jednakże, ponieważ przejście od normalnego rytmu do całkowitego bloku przedsionkowo-komorowego może nastąpić w czasie krótszym niż 24 godziny, cotygodniowe lub dwutygodniowe badania echokardiograficzne mogą być niewystarczające do wykrycia rozwijającego się bloku1. Z tego powodu rozwijane są alternatywne metody monitorowania.

Domowe monitorowanie tętna płodu

Badania wykazały, że częste, domowe monitorowanie częstości akcji serca płodu (FHRM) przy użyciu komercyjnego monitora Dopplera jest skuteczną metodą wczesnego wykrywania bloku przedsionkowo-komorowego1. W badaniu STOP BLOQ (Surveillance and Treatment to Prevent Fetal Atrioventricular Block Likely to Occur Quickly) ocenia się, czy matki z przeciwciałami anty-Ro/SSA mogą wykorzystywać domowe monitorowanie częstości akcji serca płodu w celu wykrycia bloku drugiego stopnia oraz czy szybkie leczenie deksametazonem i dożylnymi immunoglobulinami może odwrócić defekt przewodzenia1.

W badaniach potwierdzono, że domowe monitorowanie jest wykonalne i dokładne1. Co więcej, wykazano, że gdy blok drugiego stopnia jest leczony w ciągu ośmiu godzin od wykrycia, może nastąpić poprawa do normalnego rytmu, a dzieci nie wymagają rozrusznika po urodzeniu1.

Specyficzne grupy ryzyka wymagające nadzoru

Oprócz monitorowania płodów matek z przeciwciałami autoimmunologicznymi, istnieją inne grupy pacjentów, które wymagają nadzoru pod kątem bloku serca:

  • Pacjenci z chorobą Lyme – Choroba Lyme może prowadzić do zapalenia mięśnia sercowego i bloku serca. Blok serca w przebiegu boreliozy jest najczęściej odwracalny po leczeniu antybiotykami. Diagnostyka powinna być rutynowo przeprowadzana u pacjentów z blokiem serca, szczególnie na obszarach endemicznych i w miesiącach letnich1.
  • Pacjenci z chorobą Chagasa – Choroba ta staje się coraz bardziej powszechna w Stanach Zjednoczonych, z ponad 300 000 zainfekowanych osób. U pacjentów z tej grupy endemicznej z objawami sugerującymi blok serca należy przeprowadzić odpowiednie badania, ponieważ wczesna diagnostyka i leczenie są kluczowe1.
  • Pacjenci po COVID-19 – W przypadku pacjentów z manifestacjami kardiologicznymi po COVID-19, w tym z blokiem serca, wymagana jest ścisła obserwacja z indywidualnie dostosowanymi harmonogramami nadzoru1.

Trendy epidemiologiczne i czynniki ryzyka

Analizy epidemiologiczne wykazują, że częstość występowania bloku AV rośnie wraz z wiekiem i jest ściśle związana z innymi czynnikami ryzyka sercowo-naczyniowego1. Badania wieloczynnikowe wykazały, że następujące czynniki są niezależnie związane z rozwojem bloku AV1:

  • Historia palenia tytoniu
  • Powiększenie lewego przedsionka (LAD)
  • Wydłużony odstęp R-R
  • Zmniejszona częstość akcji komór

Dodatkowo, badanie z Danii wykazało, że istnieje wyraźny komponent rodzinny w występowaniu bloku serca, szczególnie w przypadkach wczesnego początku1. Ryzyko bloku AV u krewnych pierwszego stopnia pacjentów z blokiem AV było ponad 10-krotnie wyższe u potomstwa rodziców, którym wszczepiono rozrusznik przed 50. rokiem życia, co sugeruje, że czynniki genetyczne mogą odgrywać rolę w rodzinach z wczesnym wystąpieniem bloku AV1.

Typ bloku serca Częstość występowania Grupy ryzyka Uwagi
Blok pierwszego stopnia 6,84 na 100 osób – Osoby starsze
– Pacjenci afroamerykańscy
– Osoby z chorobami serca 		Może występować u zdrowych osób, ale wiąże się ze zwiększonym ryzykiem migotania przedsionków
Blok drugiego stopnia typu Mobitz I (Wenckebach) 0,5-2% zdrowych osób – Młodzi dorośli podczas snu
– Sportowcy 		Obserwowany u 1-2% zdrowych młodych ludzi, szczególnie podczas snu
Blok drugiego stopnia typu Mobitz II Rzadki u zdrowych osób – Pacjenci z chorobami strukturalnymi serca
– 1 na 30 osób z niewydolnością serca 		Występuje rzadko w populacji ogólnej
Blok trzeciego stopnia (całkowity) 0,02-0,04% populacji ogólnej – Osoby starsze z chorobami serca
– 5-10% dorosłych powyżej 70. roku życia z historią nieprawidłowości serca
– Pacjenci z cukrzycą (1,1%)
– Pacjenci z nadciśnieniem (0,6%) 		U osób pozornie zdrowych i bezobjawowych częstość wynosi zaledwie 0,001%
Wrodzony blok trzeciego stopnia 1 na 15 000-20 000 urodzeń – Płody matek z przeciwciałami anty-Ro/SSA (2%)
– Występuje częściej u płodów płci żeńskiej (60%) 		Związany z 20% śmiertelnością i zazwyczaj wymaga wszczepienia rozrusznika

Inicjatywy badawcze i przyszłe kierunki

W związku z wysokim obciążeniem zdrowotnym związanym z blokiem serca, prowadzone są różne inicjatywy badawcze mające na celu poprawę diagnozy, leczenia i zapobiegania12:

  • Badanie STOP BLOQ – To wieloośrodkowe badanie, które ocenia skuteczność domowego monitorowania częstości akcji serca płodu u matek z przeciwciałami anty-Ro/SSA. Celem jest wczesne wykrycie bloku serca u płodu i szybkie wdrożenie leczenia1.
  • Badanie LEADR LBBAP – Globalne, prospektywne, nierandomizowane badanie wieloośrodkowe, mające na celu ocenę bezpieczeństwa i skuteczności elektrody defibrylacyjnej OmniaSecure umieszczonej w pozycji stymulacji lewej odnogi pęczka Hisa (LBBAP) u pacjentów z blokiem przedsionkowo-komorowym1.

Przyszłe badania mogą skupić się na1:

  • Opracowaniu bardziej skutecznych metod nadzoru i wczesnego wykrywania bloku serca
  • Rozwijaniu nowych technik stymulacji serca, które zmniejszają ryzyko rozwoju niewydolności serca związanej z długotrwałą stymulacją prawej komory
  • Badaniu genetycznych predyspozycji do bloku serca, szczególnie w przypadkach wczesnego początku

Prowadzone są również badania nad rolą hydroksychlorochiny (HCQ) w zmniejszaniu ryzyka wrodzonego bloku serca u kobiet w ciąży z przeciwciałami anty-Ro/SSA i/lub anty-La/SSB1.

Implikacje zdrowia publicznego

Blok serca stanowi istotne obciążenie dla systemów opieki zdrowotnej na całym świecie. Mimo że dokładne dane dotyczące kosztów ekonomicznych nie są dostępne, można przypuszczać, że są one znaczące ze względu na wysoką częstość wszczepień rozruszników serca u pacjentów z blokiem serca1.

Włoskie badanie obejmujące ponad 24 000 pacjentów wykazało, że 21% osób z wszczepionym rozrusznikiem otrzymało go z powodu bloku przedsionkowo-komorowego trzeciego stopnia1. Z uwagi na fakt, że niewydolność serca dotyka ponad 64 miliony osób na całym świecie, a pacjenci z blokiem przedsionkowo-komorowym są bardziej narażeni na jej rozwój, zarówno w perspektywie krótko-, jak i długoterminowej, problem ten może mieć istotne konsekwencje dla zdrowia publicznego12.

Ważnymi elementami zdrowia publicznego związanymi z blokiem serca są1:

  • Promocja zdrowego stylu życia w celu zmniejszenia ryzyka chorób serca, które mogą prowadzić do bloku serca
  • Rutynowe badania przesiewowe w kierunku przeciwciał anty-Ro/SSA i anty-La/SSB u kobiet w wieku rozrodczym w celu zapobiegania wrodzonym blokom serca1
  • Rozwijanie lepszych strategii nadzoru i monitorowania dla osób z wysokim ryzykiem rozwoju bloku serca

Podsumowanie epidemiologii bloku serca

Blok przedsionkowo-komorowy jest istotnym problemem klinicznym, którego częstość występowania wzrasta wraz z wiekiem i obecnością innych chorób sercowo-naczyniowych12. Częstość występowania bloku pierwszego stopnia jest najwyższa, podczas gdy blok trzeciego stopnia jest stosunkowo rzadki1.

Wrodzony blok serca występuje rzadko, ale jest znaczącym problemem u płodów matek z przeciwciałami anty-Ro/SSA12. Domowe monitorowanie tętna płodu wydaje się obiecującą strategią wczesnego wykrywania i leczenia bloku serca u płodu1.

Chociaż nie ma dobrze scharakteryzowanych dużych badań dotyczących korelacji między różnymi typami bloku AV a wiekiem, rasą lub płcią1, istniejące dane sugerują, że czynniki genetyczne mogą odgrywać rolę w rodzinach z wczesnym wystąpieniem bloku AV1, a czynniki metaboliczne są związane z zwiększonym ryzykiem rozwoju bloku serca1.

Lepsze zrozumienie epidemiologii bloku serca może pomóc w opracowaniu skuteczniejszych strategii prewencyjnych, diagnostycznych i terapeutycznych dla tego istotnego klinicznie problemu zdrowotnego.

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  1. 12.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Atrioventricular Block – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK459147/
    The precise prevalence of AV blocks remains unknown due to the absence of extensive population-based studies focusing specifically on their occurrence. The estimated occurrence of autoantibody-mediated congenital AV block is approximately 1 in 15,000 births. However, it is important to note that the actual incidence may be underestimated due to cases resulting in intrauterine deaths. […] An AV block due to degeneration of cardiac conduction tissue is much more common in individuals older than 65. In contrast, the prevalence of third-degree AV block is rare in young individuals. However, one study suggested that first-degree AV block is more prevalent in African-American patients than Caucasian patients in all age groups except in the eighth decade of life. […] However, at this time, there is no well-characterized large study about the correlation between different types of AV block with age, race, or gender.
  • #1 Prevalence and risk factors of atrioventricular block among 15 million Chinese health examination participants in 2018: a nation-wide cross-sectional study | BMC Cardiovascular Disorders | Full Text
    https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02105-3
    Nationwide data on the prevalence of atrioventricular (AV) block are currently unavailable in China. Thus, we aimed to assess the prevalence and risk factors of AV block among Chinese health examination adults. […] AV block was observed in 88,842 participants, including 86,153 with first-degree, 2249 with second-degree and 440 with third-degree AV block. The age- and sex-standardized prevalence rate [95% confidence interval (CI)] of all, first-, second- and third-degree AV block were 7.06 (7.01-7.11), 6.84 (6.79-6.89), 0.18 (0.17-0.18) and 0.04 (0.03-0.04) respectively. […] The risk of AV block was associated with older age, being male and metabolic factors. […] The prevalence of AV block increased significantly with age. Managing metabolic risk factors may be beneficial for preventing AV block.
  • #1 Third-Degree Atrioventricular Block (Complete Heart Block): Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/162007-overview
    In the United States, the prevalence of third-degree atrioventricular (AV) block (complete heart block) is 0.02%. Worldwide, the prevalence of third-degree AV block is 0.04%. […] The incidence of AV conduction abnormalities increases with advancing age, resembling the age-related incidence of ischemic heart disease. An early peak in incidence occurs in infancy and early childhood due to congenital complete AV block, which is sometimes not recognized until childhood or even adolescence.
  • #1 Second degree AV block epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Second_degree_AV_block_epidemiology_and_demographics
    In the United States, the prevalence of second-degree AV block is believed to be 3 in 100,000 individuals. Men and women are affected equally by second-degree AV block. There is no racial predilection for second degree AV block. […] In the United States, the prevalence of second-degree AV block is believed to be 3 in 100,000 individual. Nearly 3% of patients with underlying structural heart disease develop some form of second-degree AV block. […] Men and women are affected equally by second-degree AV block. […] There is no racial predilection for second-degree atrioventricular block.
  • #1 Atrioventricular Block: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/151597-overview
    Epidemiology of specific AV blocks in the United States: All types of AV blocks occur more frequently in people older than 70 years, especially in those who have structural heart disease. […] First-degree AV block: Can be found in healthy adults but is associated with an increased risk of atrial fibrillation and adverse outcomes in some studies. […] Incidence increases with age. […] At age 20 years: PR interval may exceed 0.20 sec in 0.5-2% of healthy people. […] At age 60 years: Over 5% of healthy individuals have PR intervals exceeding 0.20 seconds. […] Mobitz type II second-degree AV block: Rare in healthy individuals. […] Wenckebach observed in 1-2% of healthy young people, especially during sleep. […] Congenital third-degree AV block: About 1 case per 15,000-20,000 births, primarily the result of AV node injury from maternal antibodies in women with lupus or Sjogren syndrome.
  • #1 Familial risk of atrioventricular block in first-degree relatives | Heart
    https://heart.bmj.com/content/108/15/1194
    Atrioventricular block (AVB) is the most common indication for pacemaker implantation, and the incidence of AVB increases with older age. Over the past decade, an average of 350 persons per million inhabitants have received a first-time pacemaker due to AVB in Denmark annually. […] The present nationwide study showed that the risk of AVB in first-degree relatives to patients with AVB was more than doubled compared with the background population. This risk was inversely related to the age of the index case at pacemaker implantation and was increased to more than 10-fold in offspring of parents with pacemaker implantation before the age of 50 years. […] In this study of 4648204 individuals, first-degree relatives to a patient with AVB carried an increased risk of AVB with the risk being strongly inversely associated with the age of the index case at pacemaker implantation. […] A family history of AVB is associated with an increased risk of AVB among first-degree relatives with the risk being strongly associated with age of the index case at pacemaker implantation. These findings indicate that genetic factors play a role in families with early-onset AVB.
  • #1 Third-Degree Atrioventricular Block – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK545199/
    Although AV blocks are fairly common, third-degree AV block is relatively rare. The incidence in the general population appears to be low, approximately 0.02% to 0.04%. Given the etiology of the disease, the incidence among the apparently healthy and presumptively asymptomatic individuals is as low as 0.001%. Similarly, as one looks at people with a greater disease burden, the incidence increases with a study of patients in the Veterans Health Administration, demonstrating an incidence of 1.1% in those with diabetes mellitus and 0.6% in those with hypertension. […] The long-term prognosis of third-degree AV block is not well studied (as it often requires treatment in acute settings). The prognosis likely depends on the patient’s underlying disease burden and the severity of the clinical presentation on arrival. Complete heart block is sometimes reversible in settings such as acute MI by restoring coronary perfusion and in conditions such as Lyme disease by antibiotic treatment. Historically, high-grade AV blocks have been considered a marker of poor prognosis in patients with ST-segment elevation myocardial infarction, and more recent studies indicate that this continues to be true in the era of percutaneous coronary intervention.
  • #1 Atrioventricular block | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/atrioventricular-block?lang=us
    Atrioventricular block can be found in healthy young individuals and prevalence seems to increase with age and other types of heart disease. […] Atrioventricular block can be associated with the following conditions: atrial fibrillation, cardiomyopathies, structural heart disease.
  • #1 Heart Block: Types, Causes, Symptoms, Treatment
    https://www.healthline.com/health/heart-disease/what-is-a-heart-block
    Heart block is usually the result of a trauma that affects the hearts electrical system. Your risk of heart block also increases as you get older. Other risk factors include a history of: […] A 2019 study also suggests that two key cardiovascular risk factors high blood pressure and elevated blood glucose levels are associated with higher risks of developing heart block. […] Third-degree heart block is rare, affecting less than 0.05% of the population. […] Heart block cant always be prevented. Because its often a complication of heart disease, the best way of lowering your risk is to follow a heart-healthy lifestyle that includes: […] While heart block cant always be prevented age and heart disease are the most common risk factors a heart-healthy lifestyle that reduces the risk of heart attack and cardiovascular disease may help lower the odds of developing this condition.
  • #1 Congenital heart block – Wikipedia
    https://en.wikipedia.org/wiki/Congenital_heart_block
    The congenital heart block occurs in 1 child in every 15,000 to 20,000 births. […] More than 90% of the cases are associated with autoimmune disease and transference of maternal autoantibodies. […] Without considering the gender, the age of diagnosis or the associated diseases, mortality rate is around 20%. […] The majority of CHB-related deaths occur in the first 3 months after birth followed by fetal death, and it is less common to occur after the third month of age. […] Mortality rate is very high when the disease is diagnosed prenatally, and declines dramatically with older diagnosis ages. […] Around 60% – 70% of the patients will need pace-maker implantation regardless of the age of diagnosis. […] The disease seems to affect both males and females equally. […] The survival rate is heavily affected by the associated diseases, and it is higher in autoimmune-mediated CHB patients compared to CHB patients with congenital cardiac structural problems.
  • #1 Congenital Complete Heart Block | ECR Journal
    https://www.ecrjournal.com/articles/congenital-complete-heart-block?language_content_entity=en
    White and Eustis were the first to document congenital complete heart block (CCHB) with electrocardiogram in 1921. Until the 1950s, CCHB without structural heart disease was considered rare and benign. CCHB is estimated to complicate one in 15,00022,000 live births; however, the true incidence of CCHB is unknown as there is an association with structural congenital heart disease (CHD) with a resultant high foetal mortality. Maternal autoimmune disease is often associated with isolated CCHB (not associated with underlying structural congenital heart defect). Antibodies cross the placenta and are thought to cross-react with the developing conduction system, leading to injury. Pregnancies complicated by mothers positive for anti-Ro/La antibodies result in CCHB in 15% of live infants, with a familial recurrence rate estimated at 1520%. Some studies have estimated that as many as 2030% of these infants will suffer foetal or neonatal deaths, and an estimated 10% of children with antibody-positive CCHB will be born with hydrops or congestive heart failure (CHF) secondary to intra-uterine myocarditis and/or severe brachycardia. While CCHB in the absence of immunological exposure is recognised, patients with antibody-mediated CCHB have been found to require pacing earlier in life and follow a more malignant disease course than antibody-negative patients. These antibody-positive infants experienced a higher risk of developing dilated cardiomyopathy (DCM) with clinical CHF with signs and symptoms. CCHB also occurs in the setting of complex structural heart disease (most frequently heterotaxy syndromes and/or congenitally corrected transposition of the great arteries). The combination of heterotaxy syndrome and CCHB has an extremely high mortality rate, even with pacemaker and surgical treatments.
  • #1 About The Study • Stop Bloq • Study to Prevent Fetal Heart Block
    https://stopbloq.org/about-the-study/
    Surveillance and Treatment to Prevent Fetal Atrioventricular Block Likely to Occur Quickly […] Almost all AVB develops in the second trimester of pregnancy (18-26 weeks of gestation). […] Fetal AVB occurs in 2% of pregnant women who carry anti-Ro/SSA antibodies (3, 4, 5). […] Fetal heart rate monitoring (FHRM), using a commercial Doppler monitor, is an effective early detection method for AVB. […] Weekly or biweekly fetal echos may therefore be insufficient to detect emergent CAVB and prevent the development of CAVB (11). […] Our team has shown that frequent, at-home fetal heart rate monitoring (FHRM) is an easy and accurate method for detecting irregular heart rhythms associated with emergent CAVB (12). […] Surveillance and Treatment tO Prevent Fetal AV Block Likely to Occur Quickly. […] It is anticipated that this study will: Decrease the incidence of fetal 3° AVB.
  • #1 Congenital heart block – Wikipedia
    https://en.wikipedia.org/wiki/Congenital_heart_block
    Recurrence rate: mothers who had pregnancies associated with CHB, have a 16 – 18% chance of having kids with heart block in the following pregnancy. […] A study in the United States showed that the vast majority of the affected mothers are of a Caucasian ethnicity, despite the fact that Systemic Lupus Erythematosus (SLE) is more common among minorities.
  • #1 Atrioventricular Block: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/151597-overview
    Most commonly diagnosed between 18-24 weeks gestation; may cause first-, second-, or third-degree AV block. […] Approximately 20% mortality; most surviving children require pacemakers. […] International data: The international incidence is similar to that of the United States. […] Age-, sex-, and race-related demographics: A 60% female preponderance exists in congenital third-degree AV block; for acquired third-degree AV block, a 60% male preponderance exists. No racial proclivity exists in AV blocks.
  • #1 Autoimmune congenital heart block: a case report and review of the literature related to pathogenesis and pregnancy management | Arthritis Research & Therapy | Full Text
    https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-023-03246-w
    Autoimmune congenital heart block (ACHB) occurs in 2% of women with positive anti-Ro/SSA and anti-La/SSB antibodies and causes a high risk of intrauterine fetal death, neonatal mortality, and long-term sequelae. […] In a large US-based registry of ACHB fetuses, the probability of death was 17.5%, and one third of these fetuses died in utero. […] The 2020 American College of Rheumatology Reproductive Health Management Guidelines for Rheumatoid and Musculoskeletal Diseases conditionally recommend hydroxychloroquine (HCQ) treatment for all pregnant women with positive anti-Ro/SSA and/or anti-La/SSB antibodies to minimize the risk of ACHB. […] The recommendations conditionally recommend serial (less frequent than weekly; interval not determined) fetal echocardiography, beginning at weeks 16-18 and continuing through week 26 for pregnant women with anti-Ro/SSA and/or anti-La/SSB antibodies but no infant history of ACHB or NLS. […] Routine screening of anti-Ro/SSA and anti-La/SSB antibodies among women of childbearing age is important to prevent the birth of ACHB fetuses.
  • #1
    https://link.springer.com/article/10.1007/s11926-007-0003-4
    Neonatal lupus syndrome is a model of passively acquired autoimmunity in which the pregnant woman’s serum contains specific antibodies to 52 or 60 kd SSA/Ro and/or 48 kd SSB/La, which cross the placenta and are associated with the development of congenital heart block in the fetus and/or a transient rash or various liver and blood cell abnormalities in the newborn. […] To date, congenital heart block is a permanent condition that entails significant morbidity and mortality, with nearly all affected infants requiring pacemakers and with an 80% cumulative probability of survival at 3 years of age. […] An intensive search is on for the specific etiopathophysiology and for new clinical tools to approach and treat this disease. […] Autoimmune-associated congenital heart block: Demographics, mortality, morbidity, and recurrence rates obtained from a national neonatal lupus registry.
  • #1 Home Monitoring to Detect Fetal Atrioventricular (AV) Block | Children’s Hospital Colorado
    https://www.childrenscolorado.org/advances-answers/recent-articles/fetal-av-block-monitoring/
    2-18% of pregnant women with anti-Ro/SSA autoantibodies develop fetal AV block. […] Fetal heart block (AVB) is an uncommon yet life-threatening condition that occurs in about 2% of mothers with anti-Ro/SSA (Sjogren’s) antibodies. […] Since this transition from normal rhythm to CAVB occurs in less than 24 hours, weekly or biweekly echocardiographic surveillance rarely detects 2 AVB and the window of opportunity for treatment. […] During the study, no fetal AVB was missed by at-home FHRM. […] This study confirms previous findings that at-home monitoring is feasible. […] The transition period from normal to 3 AVB is less than 24 hours and mothers can recognize the abnormal rhythm of 2 AVB. […] When treated within eight hours of detection, 2 AVB can improve to normal rhythm and babies do not need a pacemaker after birth. […] Further research into home surveillance monitoring will be able to test the hypothesis that early detection of evolving AVB could result in earlier treatment and restore 1:1 atrioventricular conduction.
  • #1 Stopping Congenital Heart Block in Its Tracks – NYU Langone Health Physician Focus
    https://physicianfocus.nyulangone.org/stopping-congenital-heart-block-in-its-tracks/
    Congenital heart block (CHB) is a key consideration when managing rheumatologic patients during pregnancy. The disorder complicates 2 percent of anti-Ro/SSA antibody-positive pregnancies and carries substantial perinatal morbidity and mortality. Almost all of the survivors require lifelong cardiac pacing. Data suggests ant-inflammatory treatment of primary and secondary (emerging) CHB can prevent progression to complete block, yet the optimal surveillance strategy to detect emergent conduction disease is unknown. […] Their Surveillance and Treatment to Prevent Fetal Atrioventricular Block Likely to Occur Quickly (STOP BLOQ) trial, supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, launched in 2020. […] The multicenter trial is assessing whether anti-Ro/SSA-positive mothers can utilize doppler-based fetal heart rate monitoring (FHRM) at home to identify second degree block, and whether rapid treatment with dexamethasone and intravenous immunoglobulin can reverse the conduction defect.
  • #1 Ambulatory Fetal Heart Rate Monitoring (FHRM) to Surveil Pregnancies at Risk for Congenital Heart Block – ACR Meeting Abstracts
    https://acrabstracts.org/abstract/ambulatory-fetal-heart-rate-monitoring-fhrm-to-surveil-pregnancies-at-risk-for-congenital-heart-block/
    Ambulatory Fetal Heart Rate Monitoring (FHRM) to Surveil Pregnancies at Risk for Congenital Heart Block […] Congenital Heart Block (CHB) complicates 2% of anti-Ro/SSA antibody positive pregnancies and carries substantial perinatal morbidity and mortality. […] However, the optimal surveillance strategy to detect rapidly transitioning and potentially reversible conduction disease is unknown. […] These data support that FHRM is feasible and accurate.
  • #1 Diagnosing Lyme Carditis Presenting With Complete Heart Block | Samarendra | Journal of Medical Cases
    https://www.journalmc.org/index.php/JMC/article/view/3529/2829
    Evidence for Lyme infection in a patient presenting with heart block should be sought, routinely, particularly in endemic areas, and during summer months. […] Diagnosis should be strongly suspected in case of a rapid fluctuation and progression of atrioventricular block, without clinical evidence of myocardial disease.
  • #1 A rare form of imported infectious heart block | Grand Rounds
    http://grandroundsjournal.com/articles/gr130015
    Chagas disease is endemic in the southern cone of Latin America and is becoming more prevalent in the United States with more than 300,000 people infected. […] Heart block from Chagas disease often occurs in the young, and is permanent; therefore, early diagnosis and treatment is crucial. […] Chagas disease is becoming more prevalent in the United States and other regions of the developed world. Patients presenting from an endemic area with suggestive symptoms require investigation to detect this diagnosis because therapy restores patients to full functional capacity in the short term; in the long term, the prognosis is uncertain but cardiac surveillance for progressive ventricular dysfunction, thrombosis, and tachyarrhythmia is indicated.
  • #1 ABSTRACT
    https://www.ejcrim.com/index.php/EJCRIM/article/download/3026/3021?inline=1
    Simultaneous atrial flutter and third-degree atrioventricular block (AVB) caused by COVID-19 infection should be treated with a pacemaker according to heart block guidelines. […] Due to a lack of long-term data, patients with cardiac manifestations from COVID-19 require close follow-up with individualized surveillance schedules. […] Surveillance guidelines for COVID-19-induced myocarditis have not been established. […] Anticoagulation should be administered for the atrial flutter until AV synchrony is achieved. […] Cardiac MRI (cMRI) and endomyocardial biopsy (EMB) remain the gold standard investigations for myocarditis confirmation.
  • #1 Analysis of the independent risk factors of second-degree atrioventric | IJGM
    https://www.dovepress.com/analysis-of-the-independent-risk-factors-of-second-degree-atrioventric-peer-reviewed-fulltext-article-IJGM
    Smoking history, LAD, R-R interval and ventricular rate were influential factors for AF combined with II AVB. […] 24-h DCG had potential diagnostic value in the occurrence of AF combined with II AVB. […] The positive detection rate of AF combined with II AVB was 97.96% in the study group, which was much higher than 85.71% in the control group. […] The smoking history, LAD, R-R interval and ventricular rate of patients in two groups had significant differences. […] AF patients with II AVB or not were selected as the dependent variable. The statistically significant indicators in Table 1 were also chosen as the dependent variable and analyzed by multivariate logistic analysis. […] The results showed that smoking history, LAD, R-R interval, and ventricular rate were all influencing factors of AF combined with II AVB.
  • #1 UCSF Atrioventricular Block Trial → Surveillance and Treatment to Prevent Fetal Atrioventricular Block Likely to Occur Quickly (STOP BLOQ)
    https://clinicaltrials.ucsf.edu/trial/NCT04474223
    Fetal complete (i.e., third degree, 3) atrioventricular block (AVB), identified in the 2nd trimester of pregnancy in an otherwise normally developing heart, is almost universally associated with maternal anti-Ro autoantibodies and results in death in a fifth of cases. […] To date treatment of 3 AVB has been ineffective in restoring normal rhythm (NR) which may be because current surveillance is limited to once-weekly fetal echocardiograms. […] A barrier to preventing progression to 3 AVB is the absence of a technique to accurately surveil for the precipitate transition from NR to 3 AVB. Surveillance limited to weekly echos (current standard of care) may be too infrequent to detect this transition period when treatment is most likely to be effective. […] We have now obviated this obstacle and shown that ambulatory FHRM by the mother at home with confirmation of abnormal findings by echo is not only feasible but may afford rapid treatment restoring NR.
  • #1 Late-Breaking Clinical Trials at Heart Rhythm 2025 Showcase Promising Outcomes for Left Bundle Branch Area Pacing in Heart Failure Treatment – HRS
    https://www.hrsonline.org/news/lcbt-showcase-promising-outcomes-left-bundle-branch-area-pacing/
    While these results are promising, ongoing large randomized controlled trials will offer further insights into the long-term benefits of left bundle branch area pacing. […] The LEADR LBBAP study, a global, prospective, non-randomized, multi-center study, sought to evaluate the safety and efficacy of the OmniaSecure defibrillation lead when placed in the LBBAP position. […] Future analyses will provide further insights into the safety and efficacy of the lead at 3-months follow-up.
  • #1 Third-Degree Atrioventricular Block | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/17971
    The recommendation is that a pacemaker is placed in patients with a persistent third-degree AV block, although the term „persistent” is often a matter of clinician judgment. An Italian survey of just over 24000 patients found that 21% received pacing for third-degree AV blocks. Although a pacemaker is a definitive treatment for patients with third-degree AV block, it does carry some burden of heart failure itself. A 2017 study concluded that patients with AV blocks are more prone to develop heart failure than those without an AV block, both acutely (over six months) and chronically (6 months to 4 years), which may be related to the dependence on frequent RV pacing.
  • #1 Late-Breaking Clinical Trials at Heart Rhythm 2025 Showcase Promising Outcomes for Left Bundle Branch Area Pacing in Heart Failure Treatment – HRS
    https://www.hrsonline.org/news/lcbt-showcase-promising-outcomes-left-bundle-branch-area-pacing/
    Heart failure impacts more than 64 million people worldwide.i […] While numerous studies have shown that cardiac resynchronization therapy (CRT) can reduce hospitalizations related to heart failure and lower all-cause mortality, biventricular pacing (BVP) has notable limitations, including a 34% rate of acute procedural failure, phrenic nerve stimulation, and increasing pacing thresholds or loss of capture.ii […] LBBAP continues to gain attention as a promising pacing option in patients with more complex conduction system diseases, particularly for patients with infranodal atrioventricular block and left bundle branch block.iii […] Our findings support the hypothesis that targeting the conduction system through left bundle branch area pacing leads to superior electrical resynchronization, resulting in better clinical outcomes, said Pugazhendhi Vijayaraman, MD, Director of Cardiac Electrophysiology, Geisinger Heart Institute, Wilkes-Barre, Pennsylvania.
  • #2 Third-Degree Atrioventricular Block – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK545199/
    Although AV blocks are fairly common, third-degree AV block is relatively rare. The incidence in the general population appears to be low, approximately 0.02% to 0.04%. Given the etiology of the disease, the incidence among the apparently healthy and presumptively asymptomatic individuals is as low as 0.001%. Similarly, as one looks at people with a greater disease burden, the incidence increases with a study of patients in the Veterans Health Administration, demonstrating an incidence of 1.1% in those with diabetes mellitus and 0.6% in those with hypertension. […] The long-term prognosis of third-degree AV block is not well studied (as it often requires treatment in acute settings). The prognosis likely depends on the patient’s underlying disease burden and the severity of the clinical presentation on arrival. Complete heart block is sometimes reversible in settings such as acute MI by restoring coronary perfusion and in conditions such as Lyme disease by antibiotic treatment. Historically, high-grade AV blocks have been considered a marker of poor prognosis in patients with ST-segment elevation myocardial infarction, and more recent studies indicate that this continues to be true in the era of percutaneous coronary intervention.
  • #2 Atrioventricular Block > Fact Sheets > Yale Medicine
    https://www.yalemedicine.org/conditions/atrioventricular-block
    Atrioventricular block is more common in older adults, and is often linked to heart conditions, such as heart attack or coronary artery disease. […] The Yale Cardiac Electrophysiology Program is an internationally recognized center for expertise in the management of arrhythmias, including atrioventricular block, says Yale Medicine cardiologist James V. Freeman, MD, MPH, MS. Yale offers state-of-the-art care, incorporating the latest medical and procedural innovations in the field to treat each patient in an individualized way. In addition, our faculty conduct cutting edge research into the underlying mechanisms and optimal treatment strategies for patients with arrhythmias, including atrioventricular block. […] Blood Disorders Surveillance and Treatment to Prevent Fetal Atrioventricular Block Likely to Occur Quickly (STOP BLOQ)
  • #2 Atrioventricular Block: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/151597-overview
    Most commonly diagnosed between 18-24 weeks gestation; may cause first-, second-, or third-degree AV block. […] Approximately 20% mortality; most surviving children require pacemakers. […] International data: The international incidence is similar to that of the United States. […] Age-, sex-, and race-related demographics: A 60% female preponderance exists in congenital third-degree AV block; for acquired third-degree AV block, a 60% male preponderance exists. No racial proclivity exists in AV blocks.
  • #2 Third-Degree Atrioventricular Block | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/17971
    Although AV blocks are fairly common, third-degree AV block is relatively rare. The incidence in the general population appears to be low, approximately 0.02% to 0.04%. Given the etiology of the disease, the incidence among the apparently healthy and presumptively asymptomatic individuals is as low as 0.001%. Similarly, as one looks at people with a greater disease burden, the incidence increases with a study of patients in the Veterans Health Administration, demonstrating an incidence of 1.1% in those with diabetes mellitus and 0.6% in those with hypertension. […] The long-term prognosis of third-degree AV block is not well studied (as it often requires treatment in acute settings). The prognosis likely depends on the patient’s underlying disease burden and the severity of the clinical presentation on arrival. Complete heart block is sometimes reversible in settings such as acute MI by restoring coronary perfusion and in conditions such as Lyme disease by antibiotic treatment. Historically, high-grade AV blocks have been considered a marker of poor prognosis in patients with ST-segment elevation myocardial infarction, and more recent studies indicate that this continues to be true in the era of percutaneous coronary intervention.
  • #2 Congenital Complete Heart Block | ECR Journal
    https://www.ecrjournal.com/articles/congenital-complete-heart-block?language_content_entity=en
    White and Eustis were the first to document congenital complete heart block (CCHB) with electrocardiogram in 1921. Until the 1950s, CCHB without structural heart disease was considered rare and benign. CCHB is estimated to complicate one in 15,00022,000 live births; however, the true incidence of CCHB is unknown as there is an association with structural congenital heart disease (CHD) with a resultant high foetal mortality. Maternal autoimmune disease is often associated with isolated CCHB (not associated with underlying structural congenital heart defect). Antibodies cross the placenta and are thought to cross-react with the developing conduction system, leading to injury. Pregnancies complicated by mothers positive for anti-Ro/La antibodies result in CCHB in 15% of live infants, with a familial recurrence rate estimated at 1520%. Some studies have estimated that as many as 2030% of these infants will suffer foetal or neonatal deaths, and an estimated 10% of children with antibody-positive CCHB will be born with hydrops or congestive heart failure (CHF) secondary to intra-uterine myocarditis and/or severe brachycardia. While CCHB in the absence of immunological exposure is recognised, patients with antibody-mediated CCHB have been found to require pacing earlier in life and follow a more malignant disease course than antibody-negative patients. These antibody-positive infants experienced a higher risk of developing dilated cardiomyopathy (DCM) with clinical CHF with signs and symptoms. CCHB also occurs in the setting of complex structural heart disease (most frequently heterotaxy syndromes and/or congenitally corrected transposition of the great arteries). The combination of heterotaxy syndrome and CCHB has an extremely high mortality rate, even with pacemaker and surgical treatments.
  • #2 Ambulatory Fetal Heart Rate Monitoring (FHRM) to Surveil Pregnancies at Risk for Congenital Heart Block – ACR Meeting Abstracts
    https://acrabstracts.org/abstract/ambulatory-fetal-heart-rate-monitoring-fhrm-to-surveil-pregnancies-at-risk-for-congenital-heart-block/
    Ambulatory Fetal Heart Rate Monitoring (FHRM) to Surveil Pregnancies at Risk for Congenital Heart Block […] Congenital Heart Block (CHB) complicates 2% of anti-Ro/SSA antibody positive pregnancies and carries substantial perinatal morbidity and mortality. […] However, the optimal surveillance strategy to detect rapidly transitioning and potentially reversible conduction disease is unknown. […] These data support that FHRM is feasible and accurate.
  • #2 Stopping Congenital Heart Block in Its Tracks – NYU Langone Health Physician Focus
    https://physicianfocus.nyulangone.org/stopping-congenital-heart-block-in-its-tracks/
    Even at this early stage we are already learning a great deal about the impact of home monitoring and the empowerment of mothers to participate in their own care. […] Although the initial results are encouraging, Dr. Buyon cautions that the study is still in its early stages, with a goal of enrolling 1,300 patients over the next four years.
  • #2 Third-Degree Atrioventricular Block | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/17971
    The recommendation is that a pacemaker is placed in patients with a persistent third-degree AV block, although the term „persistent” is often a matter of clinician judgment. An Italian survey of just over 24000 patients found that 21% received pacing for third-degree AV blocks. Although a pacemaker is a definitive treatment for patients with third-degree AV block, it does carry some burden of heart failure itself. A 2017 study concluded that patients with AV blocks are more prone to develop heart failure than those without an AV block, both acutely (over six months) and chronically (6 months to 4 years), which may be related to the dependence on frequent RV pacing.
  • #2 Prevalence and risk factors of atrioventricular block among 15 million Chinese health examination participants in 2018: a nation-wide cross-sectional study | BMC Cardiovascular Disorders | Full Text
    https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02105-3
    Nationwide data on the prevalence of atrioventricular (AV) block are currently unavailable in China. Thus, we aimed to assess the prevalence and risk factors of AV block among Chinese health examination adults. […] AV block was observed in 88,842 participants, including 86,153 with first-degree, 2249 with second-degree and 440 with third-degree AV block. The age- and sex-standardized prevalence rate [95% confidence interval (CI)] of all, first-, second- and third-degree AV block were 7.06 (7.01-7.11), 6.84 (6.79-6.89), 0.18 (0.17-0.18) and 0.04 (0.03-0.04) respectively. […] The risk of AV block was associated with older age, being male and metabolic factors. […] The prevalence of AV block increased significantly with age. Managing metabolic risk factors may be beneficial for preventing AV block.
  • #2 About The Study • Stop Bloq • Study to Prevent Fetal Heart Block
    https://stopbloq.org/about-the-study/
    Surveillance and Treatment to Prevent Fetal Atrioventricular Block Likely to Occur Quickly […] Almost all AVB develops in the second trimester of pregnancy (18-26 weeks of gestation). […] Fetal AVB occurs in 2% of pregnant women who carry anti-Ro/SSA antibodies (3, 4, 5). […] Fetal heart rate monitoring (FHRM), using a commercial Doppler monitor, is an effective early detection method for AVB. […] Weekly or biweekly fetal echos may therefore be insufficient to detect emergent CAVB and prevent the development of CAVB (11). […] Our team has shown that frequent, at-home fetal heart rate monitoring (FHRM) is an easy and accurate method for detecting irregular heart rhythms associated with emergent CAVB (12). […] Surveillance and Treatment tO Prevent Fetal AV Block Likely to Occur Quickly. […] It is anticipated that this study will: Decrease the incidence of fetal 3° AVB.
  • #3 Stopping Congenital Heart Block in Its Tracks – NYU Langone Health Physician Focus
    https://physicianfocus.nyulangone.org/stopping-congenital-heart-block-in-its-tracks/
    Congenital heart block (CHB) is a key consideration when managing rheumatologic patients during pregnancy. The disorder complicates 2 percent of anti-Ro/SSA antibody-positive pregnancies and carries substantial perinatal morbidity and mortality. Almost all of the survivors require lifelong cardiac pacing. Data suggests ant-inflammatory treatment of primary and secondary (emerging) CHB can prevent progression to complete block, yet the optimal surveillance strategy to detect emergent conduction disease is unknown. […] Their Surveillance and Treatment to Prevent Fetal Atrioventricular Block Likely to Occur Quickly (STOP BLOQ) trial, supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, launched in 2020. […] The multicenter trial is assessing whether anti-Ro/SSA-positive mothers can utilize doppler-based fetal heart rate monitoring (FHRM) at home to identify second degree block, and whether rapid treatment with dexamethasone and intravenous immunoglobulin can reverse the conduction defect.

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