Progressive Maternal Heart Block in Pregnancy Requiring Transvenous Pacing: A Case Report
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Abstract
Atrioventricular heart block (AVHB) encompasses a class of conduction abnormalities characterized by impaired electrical signal propagation within the heart. Based on the degree of dissociation, significant hemodynamic derangements may occur. During labor, rapid fluctuations in vagal tone and subsequent neurocardiogenic reflexes can cause further bradyarrhythmia and hemodynamic instability, requiring prompt intervention. This case describes a 21-year-old female with new-onset, progressive AVHB requiring transvenous pacing for labor induction and subsequent leadless pacemaker implantation post-delivery. Ultrasound-guided placement of temporary transvenous pacing wires offers a non-fluoroscopic option for management but necessitates ICU admission. This case highlights the need for novel standardized institutional protocols to ensure rapid ICU access for all obstetric patients requiring critical care. A structured approach to accessing critical care environments and interdisciplinary teams is necessary to reduce morbidity and mortality secondary to obstetric complications, including maternal AVHB.
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