[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-460781-105":59,"doc-detail-460781-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","high-grade-atrioventricular-block-and-ventricular-standstill-in-a-pregnant-patient","High-Grade Atrioventricular Block and Ventricular Standstill in a Pregnant Patient","","Heart block during pregnancy is a rare, understudied condition carrying substantial mortality risk for both mother and foetus. The severity of atrioventricular block often worsens across pregnancy, yet may resolve postpartum, implicating pregnancy-related haemodynamic changes. Management requires coordinated cardiology, obstetrics, and anaesthetic planning; pacemaker indications mirror non-pregnant practice. Anaesthetic delivery choices must account for Valsalva and neuraxial effects on maternal haemodynamics. A case report describes a pregnant patient with intermittent high-grade AVB and ventricular standstill, structurally normal imaging, successful leadless pacing, uncomplicated vaginal delivery, and no symptom recurrence.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/high-grade-atrioventricular-block-and-ventricular-standstill-in-a-pregnant-patient/460781/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/high-grade-atrioventricular-block-and-ventricular-standstill-in-a-pregnant-patient/460781.png","ImageObject",300,407,{"name":92,"@type":93},"Margaret","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is heart block during pregnancy considered high-risk?","Question",{"text":113,"@type":114},"It is rare and understudied, but it poses considerable mortality risks to both the mother and foetus. The severity of atrioventricular block tends to worsen throughout pregnancy.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What investigation findings were reported in this case?",{"text":118,"@type":114},"Transthoracic echocardiogram and cardiac magnetic resonance imaging showed a structurally normal heart. Telemetry documented intermittent high-grade AVB with ventricular standstill up to seven seconds during symptoms.",{"name":120,"@type":111,"acceptedAnswer":121},"How was the patient managed and what was the outcome?",{"text":122,"@type":114},"A leadless pacemaker was implanted, then delivery proceeded with an uncomplicated vaginal birth. The patient experienced no recurrence of symptoms, and postpartum imaging confirmed normal cardiac structure.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},460781,1790812635,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},137451207643,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Review began 11/09/2025  \nReview ended 12/06/2025  \nPublished 12/09/2025  \n© Copyright 2025  \nBurke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98855  \nOpen Access Case Report  \nHigh-Grade Atrioventricular Block and Ventricular Standstill in a Pregnant Patient  \nPaul Burke 1, Leeona Gallagher 1 , Timothy Witting 2 , Devind Bhullar 3  \n1. Internal Medicine, Armadale Hospital, Perth, AUS 2. Cardiology, Sir Charles Gairdner Hospital, Perth, AUS 3. Cardiology, St. John of God Subiaco Hospital, Perth, AUS  \nCorresponding author: Paul Burke, [paul.burke96@hotmail.com](paul.burke96@hotmail.com)  \nAbstract  \nHeart block during pregnancy is a rare and understudied condition that poses considerable mortality risks to both the mother and foetus. The severity of atrioventricular block (AVB) tends to worsen throughout pregnancy but may resolve postpartum in some patients, suggesting that its aetiology is linked to the haemodynamic changes of pregnancy. Management of this condition necessitates a multidisciplinary approach across cardiology, obstetrics, and anaesthetics. Pacemaker indications remain consistent with those for non-pregnant patients and can be inserted safely, particularly after the first trimester. Anaesthetists must consider the potential impacts ofthe Valsalva manoeuvre and neuraxial anaesthesia on maternal haemodynamics during delivery. Decisions regarding the method of delivery should be based solely on obstetric indication. This report details the case of a pregnant woman who presented with pre-syncope attributed to intermittent high-grade AVB with ventricular standstill. Transthoracic echocardiogram and cardiac magnetic resonance imaging performed during and after pregnancy, respectively, revealed a structurally normal heart. The patient was successfully treated with a leadless pacemaker, had an uncomplicated vaginal delivery and experienced no recurrence of symptoms.  \nCategories: Obstetrics/Gynecology, Cardiology, Anesthesiology  \nKeywords: atrioventricular heart block, av block in pregnancy, complete heart block in pregnancy, high-grade av block, ventricular standstill  \nIntroduction  \nAtrioventricular block (AVB) during pregnancy is rare, characterised by disrupted electrical coordination between the atria and ventricles [1] . AVB classifications are identified via electrocardiogram (ECG), with causes divided into acquired and congenital [2-5]. The degree of AVB tends to progressively worsen as pregnancy continues, potentially leading to poor outcomes if mismanaged [6] . Existing guidelines are based on case reports, small studies and expert opinion, yet uncertainties remain [1,7,8]. We discuss a 35-week primigravida patient with high-grade AVB and ventricular standstill, exploring the potential causes, investigations and management. Following a systematic search of PubMed, Medline, and Embase using terms “AV block,” “heart block” and “pregnancy”, we believe this is the first documented case of a leadless pacemaker used for high-grade AVB and ventricular standstill in pregnancy.  \nCase Presentation  \nA 35-week pregnant nulliparous woman in her 30s presented to her obstetrician with repeated episodes of dizziness and nausea occurring at rest. Her medical history included iron and vitamin D deficiency, corrected with medication. She had no family history of cardiac disease and no history of excessive alcohol consumption, smoking or illicit drug use. Her medications included iron polymaltose 100mg, cholecalciferol 25mcg, and multivitamins. She was referred to cardiology for pre-syncope workup; her physical examination and vital signs were normal. Initial tests, including an ECG, blood tests (detailed below) and echocardiogram were also normal. During a 24-hour period of telemetry, she ex","cbCaiuXCaSK7mX1q","https://ap.wps.com/l/cbCaiuXCaSK7mX1q","pdf",3371423,"English","# Abstract\n# Introduction\n# Case Presentation\n# Investigations","[{\"question\":\"Why is heart block during pregnancy considered high-risk?\",\"answer\":\"It is rare and understudied, but it poses considerable mortality risks to both the mother and foetus. The severity of atrioventricular block tends to worsen throughout pregnancy.\"},{\"question\":\"What investigation findings were reported in this case?\",\"answer\":\"Transthoracic echocardiogram and cardiac magnetic resonance imaging showed a structurally normal heart. Telemetry documented intermittent high-grade AVB with ventricular standstill up to seven seconds during symptoms.\"},{\"question\":\"How was the patient managed and what was the outcome?\",\"answer\":\"A leadless pacemaker was implanted, then delivery proceeded with an uncomplicated vaginal birth. The patient experienced no recurrence of symptoms, and postpartum imaging confirmed normal cardiac structure.\"}]","High-Grade Atrioventricular Block and Ventricular Standstill in a Pregnant Patient | PDF",1790759525,15]