Case 5: Paced Rhythm in a 12-Year Old Girl

A 12-year-old girl who previously had a second-degree congenital atrioventricular block developed progression to third degree block, resulting in occurrence of symptoms such as dizziness and near-fainting. She did not experience any loss of consciousness. Given the alarming symptoms, a decision was made to proceed with permanent cardiostimulation with a single chamber pacemaker. The Holter electrocardiogram seen in the image was conducted when the girl was 16 years old. She had yearly evaluations consisting of exercise testing and Holter ECG. She showed no symptoms for a period of 4 years. In case symptoms consistent with pacemaker syndrome, an upgrade to a double chamber pacemaker will be proposed (Figs. 11.1, 11.2, 11.3, 11.4, 11.5, 11.6, 11.7, 11.8, 11.9, 11.10, 11.11, 11.12, 11.13, and 11.14).