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Complete atrioventricular block during neonatal intubation: a case report

Year: 2025

Type: article

Abstract: Preterm infants often experience side effects from intubation. Desaturation and sinus bradycardia are frequent. Atropine as premedication mitigates these risks. We report the occurrence of severe bradycardia related to atrioventricular block during intubation. The infant experienced severe bradycardia not responsive to effective endotracheal ventilation. The electrocardiogram trace displayed an initial 2:1 Mobitz II block with a rapid progression to complete atrioventricular block. Congenital atrioventricular block is mostly related to atrioventricular node lesions by maternal anti-SSA/anti-SSB antibodies, but, in some cases, atrioventricular block may be paroxysmal and vagally mediated. Although most rhythm disturbances secondary to intubation are sinus bradycardias, other bradyarhythmia, such as atrioventricular block, should be considered and treated rapidly. Clues for non-sinus bradycardia include initial sharp decrease in heart rate, and a fixed low heart rate despite adequate ventilation.

Source: Resuscitation Plus

DOI: 10.1016/j.resplu.2025.100978

Authors: Justine Dauby, Caroline Jacquemart, Sophie Tribolet, Vincent Rigo

Institutions: University of Liège, Centre Hospitalier Universitaire de Liège, Centre hospitalier régional de la Citadelle

Language: English

Topic: Airway Management and Intubation Techniques

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,450