Page 1 of 1: congenital chb

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The AV node and the His bundle originate as separate structures in foetal development, and later join together. Anatomical studies have shown the basic lesion in congenital CHB to be a discontinuity between the atrial musculature and the AV node (or His bundle if the AV node is absent). The cause is unknown in the majority of infants, but CHB is associated with foetal myocarditis, idiopathic haemorrhage and necrosis involving the conducting tissue, and degeneration and fibrosis related in some instances to the trans-placental passage of anti-Ro antibody and other immune complexes from mothers with SLE. Other forms of congenital heart disease are also associated with CHB, most common being congenitally corrected transposition of the great arteries. The diagnosis is suggested by foetal bradycardia (HR 40-80min) or by foetal ECHO. Treatment is not required unless there are symptoms. Digitalization is recommended for babies in CCF. Sympathomimetic drugs (e.g. isoprenaline) and atropine do not have permanent and beneficial effects. CCF and Stokes-Adams attacks are indications for pacemaker implantation at any age.

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