Newborns with congenital complete heart block may require advanced stabilization at birth, and a structured delivery-room strategy incorporating anticipatory respiratory and hemodynamic support, including transcutaneous pacing in selected unstable newborns, provides a framework for anticipating potential stabilization needs.
Congenital complete heart block was diagnosed prenatally in the majority of cases, with prematurity occurring in most affected newborns.
The majority of newborns with CCHB required respiratory support in the delivery room.
Following NICU admission, a substantial proportion of newborns with CCHB required invasive mechanical ventilation, inotropic support, and invasive pacing.
Survival to neonatal discharge was high despite the significant morbidity associated with CCHB.
A structured delivery-room stabilization protocol was introduced in 2014, incorporating anticipatory cardiorespiratory and pacing readiness measures.
This research describes 11 years of experience managing newborns with congenital complete heart block (CCHB), a rare but serious condition where the heart beats dangerously slowly due to blocked electrical signals. The study followed 14 babies born with this condition at a single specialized hospital between 2009 and 2020. Most cases were detected before birth, but the condition still posed major challenges at delivery—10 of the 14 babies needed breathing support in the delivery room, and 2 required emergency interventions including a temporary external pacemaker, a breathing tube, and medication to speed up the heart rate. After being admitted to the neonatal intensive care unit, many babies needed further intensive interventions: over half ultimately required a permanent or temporary internal pacemaker, and some needed ventilators or medications to support heart function. One baby needed ECMO, a form of life support that does the work of the heart and lungs. Despite this significant burden of illness, 13 of the 14 babies survived to hospital discharge. In 2014, the hospital introduced a structured, CCHB-specific delivery-room plan that prepared the medical team in advance with the right equipment and medications ready at birth. This research suggests that babies born with CCHB often need more intensive support at birth than standard newborn resuscitation guidelines provide, and that having a specific, pre-planned approach—including a team ready to provide breathing support, heart-rate medications, and temporary pacing immediately—may help improve outcomes. The findings highlight the importance of prenatal diagnosis and multidisciplinary teamwork in preparing for these complex deliveries.
Sarrato S, Martín T, Chamorro I, Sarrato G, Bravo D, Luna M. (2026). Perinatal management and delivery-room stabilization in congenital complete heart block: an 11-year experience at a tertiary center.. European journal of pediatrics. https://doi.org/10.1007/s00431-026-07532-y