Surgical Complete Heart Block Alternating with Sinus Rhythm and Right Bundle Branch Block with Left Anterior Hemiblock

¹ Assistant Professor of Pediatrics, Pediatric Cardiologist

A patient is presented who developed transient complete heart block immediately following surgical repair of tetralogy of Fallot. Forty-three days postoperation sinus rhythm with a pattern of right bundle branch block—left anterior hemiblock replaced the complete heart block. Five and one-half years later the block recurred and eight and one-quarter years later it was replaced by sinus rhythm with the right bundle branch block—left anterior hemiblock pattern. This patient demonstrates the lability of the right bundle branch block-left anterior hemiblock pattern in a surgical situation. Even though complete heart block is replaced by sinus rhythm, attention must be given to the probability of recurrence of the block and the neede for artificial pacing.