Management and Outcomes of Congenital Atrioventricular Block in Neonates: A 6-Year Experience at a Tunisian Tertiary Center

 

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Abstract

Background

Congenital atrioventricular block (CAVB) is a rare and serious condition often associated with maternal autoimmune diseases or congenital heart defects. This study aims to evaluate the clinical presentation, management, and outcomes of neonates diagnosed with CAVB.

Methods

We conducted a retrospective study from January 2018 to December 2024, including eight neonates diagnosed with CAVB. Data on demographics, clinical features, treatment, and follow-up were analyzed.

Results

All cases were prenatally diagnosed between 20 and 25 weeks of gestation, with positive anti-SSA/SSB antibodies in five cases. Management included cesarean delivery, Holter ECG monitoring, and pacemaker implantation for four patients. One case resulted in intrauterine fetal death, and two patients died in the neonatal period. Survivors had successful pacemaker implantation with an average follow-up of 18 months.

Conclusion

Early prenatal detection and timely management of CAVB are crucial. Pacemaker implantation significantly improves survival, though challenges such as resource limitations and the lack of long-term follow-up data remain. Future studies should address these gaps to optimize care for CAVB patients.

Authors' Contributions

This work was performed in collaboration with all the authors. Material preparation, data collection, and analysis were performed by R.B.A., H.C., and W.B.A. The first draft of the manuscript was written by R.B.A. and S.H. N.B.A. and K.S. were involved in collecting and reviewing the bibliography and proposing recommendations for writing the article. S.K. and K.N. commented on previous versions of the manuscript. All authors have read and approved the final manuscript.

Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was obtained from the Ethical Committee of Maternity and Neonatology Center of Tunis (November 2024). All patients' parents received explanations of the purposes, procedures, risks, and benefits of this study.

Consent to Participate

Informed consent was obtained from all the participants' parents included in the study.

Publication History

Received: 16 January 2025

Accepted: 12 March 2025

Article published online:
09 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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