Case reports Complete heart block due to Wegener’s granulomatosis: a case report and literature review

Abstract

Involvement of the conduction system of the heart in Wegener’s granulomatosis (WG) is rare. We present a 53-year-old man with WG pulmonary, renal and left eyeball involvement and with a high initial level of cANCA (1: 640). He was treated with steroids, cyclophosphamide and cyclosporine. After 14 months he presented with lethargy and presyncope due to a complete atrio-ventricular block with an escape rhythm of 35 beats/min. The temporary pacing electrode was inserted, followed by permanent DDDR pacemaker implantation on the third day as the block persisted despite WG treatment intensification. Clinical picture showed the disease in a progressive state.