Sinus node function in children with congenital complete atrioventricular block

Aims Children with congenital complete atrioventricular block (CCAVB) often need pacemaker therapy. In these children, it may be preferable to use single-lead VDD pacing, but for VDD pacing a normal sinus node function is required. Our aim was to study sinus node function in children with CCAVB. Methods and results We longitudinally evaluated sinus rate in 36 children with CCAVB and normal anatomy of the heart. The rate of sinus rhythm on a 12-lead ECG, in Hotter recordings, and exercise tests were evaluated at regular intervals. Age at the first visit of the children was 2.5 +/- 3.3 years (mean +/- SD). Follow-up was 10.6 +/- 7.3 years. The rate of sinus rhythm on a 12-lead ECG was at every age within the normal values for age (e.g. 0-1 year: 153 +/- 24 bpm, and 17-18 years: 76 +/- 4 bpm). Lowest and highest sinus rates in the Hotter recordings were normal. During exercise, mean sinus rate in the total group of children increased from 92 +/- 8 at rest to 171 +/- 9 bpm at maximal exercise. Conclusion We conclude that sinus node function is normal in children with CCAVB. Because of the normal increase in sinus rate during exercise, a single-lead VDD pacemaker can be safety implanted in these children.