OBJECTIVE: Bradyarrhythmia related to Patent Ductus Arteriosus (PDA) closure is a very rare complication. Commonly associated with its proximity to vagal trunk, any intervention done within the PDA may pose a risk of bradycardia, notably on open ligation procedure, but not on percutaneous closure. Its occurence on percutaneous approach have been related with non specific inflamation process. We present case of reversible spontaneous bradyarrhythmia following percutaneous PDA closure.
CASE: A 10 years old female patient was admitted for elective PDA closure using percutaneous approach by PDA occluder device. Previous transthoracal
echocardiography showed a 7.8 mm PDA with a left to right shunt, otherwise unremarkable findings. Pre-procedural electrocardiogram shows a normal sinus rhythm. A conventional dual cathether approach from Aorta and Pulmonary Artery was done for successful device delivery and deployment, which was then concluded with stable hemodynamic, and a heart rate of 90 beats/minute. Twelve hours after procedure, patient developed an asymptomatic sinus bradycardia, accompanied by varying degree of sinoatrial block and pauses. A 30 days treatment of oral dexamethasone resulted in successful resolution of the bradyarrhythmia.
CONCLUSION: Bradyarrhythmia following a percutaneous PDA occluder procedure is a rare phenomenon that may be related with inlammation. Steroid may serve as a reliable option for this situation.