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Query: Hi , We have a baby who is 1 month old and now the heart rate is 75 beats per minute. Doctors are saying it is A-V disassociation. Will it recover as he grows? When born it was around 50-55 beats per minute. Please suggest.

Answer: AV dissociation right from birth may be related to AV block. AV block may be due to a congenital heart defect, a conduction problem or presence of antibodies. Those AV block with structurally abnormal heart have persistence of the problem and have symptoms related to the primary heart disease. Those children with structurally normal heart continue to have low rates. Surprisingly, in some patients, higher degrees of AV block may revert to a lower degree of AV block in few cases reported in the world. Patients have reverted to normal sinus rhythm with lst-degree AV block as late as their 3rd decade of life. However there is always a risk of sudden abnormal impulse and fainting attack. Despite the absence of symptoms in childhood, 50 percent of patients will develop symptoms in adulthood. In symptomatic patients, pacemaker may be required.

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