Optimal pacing in congenital complete atrioventricular block of immunological origin: interest of multisite stimulation

An infant with a congenital auriculoventricular block (CAVB) of immunological origin was diagnosed prenatally. The mother had Gougerot‐Sjögren disease with positive anti‐Sjogren's Syndrome A (SSA) and Sjogren's Syndrome B (SSB) serologies. Cardiac pacing was necessary and the epicardial route was chosen. Considering the left ventricular (LV) dilatation, biventricular (BiV) stimulation was preferred to the usual DDD mode, presumed to have a deleterious long‐term effect. Echographic parameters were better with BiV stimulation: the asynchronism induced by mono‐RV stimulation was corrected and the QRS complexes were narrower. BiV pacing of a CAVB with LV dilation looks clinically and echographically attractive but needs to be validated in the long term.