Clinical aspects of complete atrioventricular block following irradiation of the chest

We investigated clinical aspects of complete atrioventricular block (CAVB) after therapeutic irradiation of the chest. We report on three cases. The patients developed CAVB on an average of 19 years after irradiation. All patients had various abnormal electrocardiograms consistent with infranodal block. They also had valvular disease and pericardial effusion, and therefore they developed heart failure at CAVB. In one patient the brachiocephalic vein was occluded, so we needed to pay special attention to the possibility of vascular injury when conducting a venous pacemaker implantation. After irradiation of the chest we need to observe patients carefully over an extended period and pay attention to electrocardiographic and echocardiographic findings. (author)