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A 53-year-old male was admitted due to an asymptomatic third degree atrioventricular (AV) block of proximal type (QRS duration below 0,12 sec.). With telemetry a normal heart rate was observed and a stress test showed a maximum heart rate of 101% of the expected. Blood samples and stress echo-cardiography showed normal values. Permanent pacemaker (PM) placement was rejected and the patient was followed in the outpatient clinic. PM implantation carries a risk of complications but without it the condition can progress. Treatment of asymptomatic third degree AV-block is debated and not entirely clear.
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Rev Cardiovasc Med
August 2025
Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, 1090 Brussels, Belgium.
Despite continued advancements in transcatheter aortic valve implantation (TAVI) techniques, the incidence of permanent pacemaker implantation (PPI) remains substantial. Established predictors of PPI include advanced age, pre-existing electrocardiographic conduction abnormalities, prosthetic valve type, implantation depth, and anatomical parameters, such as membranous septum length, which are currently under active investigation. In routine clinical practice, the management strategy often involves the temporary placement of a transvenous pacemaker lead, followed by a period of observation.
View Article and Find Full Text PDFJACC Case Rep
September 2025
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Background: Cardiac sarcoidosis (CS) usually affects the left ventricle and presents with nonspecific features like conduction abnormalities and ventricular arrhythmias. However, right ventricle (RV)-dominant involvement has been increasingly reported, making diagnosis difficult.
Case Summary: A 55-year-old man presented with palpitations.
Open Access Rheumatol
August 2025
Department of Rheumatology and Immunology, the First Affiliated Hospital, Jinan University, Guangzhou, 510632, People's Republic of China.
Objective: To evaluate the efficacy of baricitinib in combination therapy for managing refractory, rapidly progressive systemic sclerosis (SSc) with severe cardiac conduction defects and interstitial lung disease (ILD).
Methods: A 48-year-old male patient with SSc complicated by significant cardiac enlargement, third-degree atrioventricular block, heart failure, progressive ILD, and partial intestinal obstruction was included in the study. Prior treatments with mycophenolate mofetil (MMF), tacrolimus, and cyclophosphamide (CTX) had shown limited efficacy.
Eur Heart J Case Rep
September 2025
Duke University Medical Center, Division of Cardiology, Box 3182, Durham, NC 27710, USA.
Background: Genetic aetiologies of early-onset arrhythmias and cardiomyopathy (CM) are common, but timely diagnosis requires a high index of suspicion.
Case Summary: An asymptomatic 47-year-old man presented to cardiology clinic for smartwatch low-rate alarms. His brother had exertional syncope and died in his 20s from heart failure.
Heart Rhythm O2
August 2025
Department of Cardiology, Rouen University Hospital, UNIROUEN, INSERM U1096, Rouen, France.
Background: A high burden of right ventricular pacing (RVP) increases the risk of hospitalization because of heart failure. Data on predictive factors for high burden of RVP in patients with permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) are limited.
Objective: This study aimed to identify predictors of high RVP burden in patients with current indications for PPI after TAVR.