Congenital heart block

A 14 year old male resident of Pondicherry came to JIPMER hospital with history of recurrent episode of syncope since last one month, patient went to local hospital and diagnosed to have Complete heart block and referred to our  hospital for further management. During evaluation at our hospital patient pulse was 70 beats per minute, BP-110/70 mmhg, CVS-S1S2 normal, RS-Bilateral normal vesicular breath sound were present. Previous hospital ECG was not available at the time  of evaluation at our hospital. ECG of the patient done at our hospital is shown below

ECG 1(Click on the ECG to enlarge it)

Description of the ECG-Sinus rhythm at 84 beats per minute, PR interval 360 msec, Normal axis, narrow QRS complex, no ST-T wave changes QT interval 360 msec, QTc-430 msec so the ecg of the patient was suggestive of first degree AV block

ECG 2

Sinus rhythm at 75 beats per minute, normal axis, narrow QRS complex, PR interval 320 msec, no ST-T wave changes seen so the ECG is suggestive of first degree AV block.

Patient underwent EPS study which was suggestive of suprahisian second degree AV block. Patient underwent successful pacemaker insertion at our  centre.

Thank you
Dr Praveen Gupta