High Degree Atrioventricular Block and Syncope in the Tetralogy of Fallot (TOF)

Delarue A, Houeijeh A and Godart F

Department of Medicine, Laboratoire d'anatomie, France
Department of Medicine, Hospital Cardiologique, France
Department of Medicine, University Lille, France

^*Correspondance to: Delarue A 

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Abstract:

Introduction: TOF is the most frequent congenital cyanogen cardiopathy. Sudden death is the most frequent adverse event after surgical treatment, mostly due to Serious Ventricular Rhythm Trouble. High degree atrioventricular block is rare cause of syncope or sudden death especially late after complete correction.Case
Presentation: We describe here the case of a 49 years old patient suffering of a regular TOF operated at the age of six followed by a total atrioventricular block during post-operative period, which quickly and spontaneously self-resoluted, an which presented recently severe syncope. There is no argument for extra cardiac explanation. EKG found total right bundle-branch block, left axis and an anterior left bundle-branch half-block. The echocardiography found a TOF corrected with good results (normal volume of the right cavities and a minor pulmonary leakage). The programmed ventricular stimulation was negative and electrophysiological study founding a long HV delay leading to an implantation of pacemaker.Discussion: The HDAB diagnosis in these situations is not that easy from an epidemiological point of view and pathophysiology, but it may help avoid the excessive implantation of automatic implantable defibrillator. A good correction result, trans-annular patch absence and the EKG aspect should evoke this diagnostic.

Keywords:

Syncope; Fallot; Total atrioventricular block; Late; Pacemaker

Cite the Article:

Delarue A, Houeijeh A, Godart F. High Degree Atrioventricular Block and Syncope in the Tetralogy of Fallot (TOF). Ann Clin Case Rep. 2017; 2: 1455.