Medication Summary
Intrauterine treatments used for congenital atrioventricular block (CAVB) include chronotropic agents, inotropic agents, steroids, and plasmapheresis. In general, medications are not necessary in children with complete CAVB. Emergency use of chronotropic medications, with or without inotropic agents, may be helpful in fetuses and newborns with hydrops fetalis, congestive heart failure, or low cardiac output.
Some investigators have suggested the use of immunosuppressive agents in fetuses and newborns to potentially slow or halt progressive CAVB in utero. This is currently being evaluated as a prospective study.
The use of steroids or immunoglobulins may be helpful in early first- and second-degree heart block and in reducing associated myocardial dysfunction.
Corticosteroids
Class Summary
Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. They modify the body's immune response to diverse stimuli.
Dexamethasone (Baycadron, Dexamethasone Intensol)
Dexamethasone may produce significant clinical responses in some patients. It may be helpful in early first- and second-degree heart block and in reducing associated myocardial dysfunction.
Blood Products
Class Summary
These agents are used to improve the clinical aspect of the disease. It may reduce associated myocardial dysfunction.
Immune globulin intravenous (Gamunex, Octagam, Gammaplex, Gammagard)
This provides an antibody-mediated blockade of Fas-Fas ligand interactions involved in the epidermal necrosis of toxic epidermal necrolysis–like cutaneous lupus erythematosus.
