How can a complete heart block be treated in a neonate?

In a neonate diagnosed with complete heart block, the most effective treatment involves the implantation of a pacemaker. Complete heart block, also known as third-degree atrioventricular (AV) block, results in a complete failure of electrical signals to travel from the atria to the ventricles. This can lead to a dangerously slow heart rate and, ultimately, inadequate blood flow to the body, which can pose significant risks for the neonate.

Pacemaker implantation is indicated in this situation because it provides an artificial means to regulate the heart’s rhythm and ensure that the ventricles continue to contract in a timely manner, thereby supporting adequate circulation. This intervention is crucial, especially since neonates may not tolerate prolonged bradycardia (abnormally slow heart rate) and may experience serious complications if timely action is not taken.

While medications may temporarily manage some symptoms, they do not effectively resolve the underlying conduction issue associated with complete heart block. Close monitoring is essential to observe changes in the neonate's condition but is not a definitive treatment. Surgery may be considered in certain scenarios, such as correcting structural heart defects, but it is not the first-line approach specifically for complete heart block. Thus, pacing is the recognized and effective treatment for restoring normal cardiac function