{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T13:02:08Z","timestamp":1773666128481,"version":"3.50.1"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"\n OBJECTIVES:<\/jats:title>\n Multisystem inflammatory syndrome in children (MIS-C) has spread through the pediatric population during the coronavirus disease 2019 pandemic. Our objective for the study was to report the prevalence of conduction anomalies in MIS-C and identify predictive factors for the conduction abnormalities.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n We performed a single-center retrospective cohort study of pediatric patients &lt;21 years of age presenting with MIS-C over a 1-month period. We collected clinical outcomes, laboratory findings, and diagnostic studies, including serial electrocardiograms, in all patients with MIS-C to identify those with first-degree atrioventricular block (AVB) during the acute phase and assess for predictive factors.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Thirty-two patients met inclusion criteria. Median age at admission was 9 years. Six of 32 patients (19%) were found to have first-degree AVB, with a median longest PR interval of 225 milliseconds (interquartile range 200\u2013302), compared with 140 milliseconds (interquartile range 80\u2013178) in patients without first-degree AVB. The onset of AVB occurred at a median of 8 days after the initial symptoms and returned to normal 3 days thereafter. No patients developed advanced AVB, although 1 patient developed a PR interval &gt;300 milliseconds. Another patient developed new-onset right bundle branch block, which resolved during hospitalization. Cardiac enzymes, inflammatory markers, and cardiac function were not associated with AVB development.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n In our population, there is a 19% prevalence of first-degree AVB in patients with MIS-C. All patients with a prolonged PR interval recovered without progression to high-degree AVB. Patients admitted with MIS-C require close electrocardiogram monitoring during the acute phase.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2020-009738","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T13:25:12Z","timestamp":1605187512000},"source":"Crossref","is-referenced-by-count":52,"title":["MIS-C and Cardiac Conduction Abnormalities"],"prefix":"10.1542","volume":"146","author":[{"given":"Nak Hyun","family":"Choi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Fremed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Starc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Weller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Cheung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Ferris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric S.","family":"Silver","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Liberman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","reference":[{"issue":"6","key":"2022021419590708700_B1","doi-asserted-by":"crossref","first-page":"e20200702","DOI":"10.1542\/peds.2020-0702","article-title":"Epidemiology of COVID-19 among children in China","volume":"145","author":"Dong","year":"2020","journal-title":"Pediatrics"},{"issue":"10239","key":"2022021419590708700_B2","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1016\/S0140-6736(20)31103-X","article-title":"An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study","volume":"395","author":"Verdoni","year":"2020","journal-title":"Lancet"},{"key":"2022021419590708700_B3","author":"Centers for Disease Control and Prevention"},{"issue":"14","key":"2022021419590708700_B4","doi-asserted-by":"crossref","first-page":"422","DOI":"10.15585\/mmwr.mm6914e4","article-title":"Coronavirus disease 2019 in children - United States, February 12\u2013April 2, 2020","volume":"69","author":"CDC COVID-19 Response Team","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"9","key":"2022021419590708700_B5","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1016\/j.jaccas.2020.04.026","article-title":"Heart brake: an unusual cardiac manifestation of COVID-19","volume":"2","author":"Kir","year":"2020","journal-title":"JACC Case Rep"},{"issue":"7","key":"2022021419590708700_B6","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1017\/S1047951120001778","article-title":"Cardiac workup and monitoring in hospitalised children with COVID- 19","volume":"30","author":"Fremed","year":"2020","journal-title":"Cardiol Young"},{"key":"2022021419590708700_B7","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/BF02083144","article-title":"Normal ECG standards for infants and children","volume":"1","author":"Davignon","year":"1980","journal-title":"Pediatr Cardiol"},{"issue":"10239","key":"2022021419590708700_B8","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1016\/S0140-6736(20)31129-6","article-title":"Kawasaki-like disease: emerging complication during the COVID-19 pandemic","volume":"395","author":"Viner","year":"2020","journal-title":"Lancet"},{"issue":"5","key":"2022021419590708700_B9","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1161\/CIRCULATIONAHA.120.048360","article-title":"Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic","volume":"142","author":"Belhadjer","year":"2020","journal-title":"Circulation"},{"issue":"7","key":"2022021419590708700_B10","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1001\/jamacardio.2020.1017","article-title":"Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19)","volume":"5","author":"Guo","year":"2020","journal-title":"JAMA Cardiol"},{"issue":"5","key":"2022021419590708700_B11","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1007\/s00134-020-05991-x","article-title":"Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. [published correction appears in Intensive Care Med. 2020;46(6):1294\u20131297]","volume":"46","author":"Ruan","year":"2020","journal-title":"Intensive Care Med"},{"issue":"5","key":"2022021419590708700_B12","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s00246-002-0402-2","article-title":"The clinical course of acquired complete heart block in children with acute myocarditis","volume":"24","author":"Batra","year":"2003","journal-title":"Pediatr Cardiol"},{"issue":"2","key":"2022021419590708700_B13","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s00246-012-0467-5","article-title":"Rhythm and conduction analysis of patients with acute rheumatic fever","volume":"34","author":"Balli","year":"2013","journal-title":"Pediatr Cardiol"},{"issue":"3","key":"2022021419590708700_B14","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s00246-018-2003-8","article-title":"Advanced heart block in children with Lyme disease","volume":"40","author":"Bolourchi","year":"2019","journal-title":"Pediatr Cardiol"},{"issue":"6","key":"2022021419590708700_B15","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1017\/S104795111000079X","article-title":"Asymptomatic rhythm and conduction abnormalities in children with acute rheumatic fever: 24-hour electrocardiography study","volume":"20","author":"Karacan","year":"2010","journal-title":"Cardiol Young"},{"issue":"1","key":"2022021419590708700_B16","doi-asserted-by":"crossref","first-page":"8","DOI":"10.7326\/0003-4819-93-1-8","article-title":"Lyme carditis: cardiac abnormalities of Lyme disease","volume":"93","author":"Steere","year":"1980","journal-title":"Ann Intern Med"},{"issue":"5","key":"2022021419590708700_B17","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2008-3058","article-title":"Lyme carditis in children: presentation, predictive factors, and clinical course","volume":"123","author":"Costello","year":"2009","journal-title":"Pediatrics"},{"issue":"2","key":"2022021419590708700_B18","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.hlc.2017.12.005","article-title":"Outcomes of heart block in myocarditis: a review of 31,760 patients","volume":"28","author":"Ogunbayo","year":"2019","journal-title":"Heart Lung Circ"},{"key":"2022021419590708700_B19","volume-title":"Streptococcus Pyogenes: Basic Biology to Clinical Manifestations","author":"Sika-Paotonu","year":"2016"},{"issue":"1","key":"2022021419590708700_B20","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1136\/hrt.33.1.12","article-title":"Atrioventricular dissociation in acute rheumatic fever","volume":"33","author":"Cristal","year":"1971","journal-title":"Br Heart J"},{"issue":"17","key":"2022021419590708700_B21","doi-asserted-by":"crossref","first-page":"e927","DOI":"10.1161\/CIR.0000000000000484","article-title":"Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association","volume":"135","author":"McCrindle","year":"2017","journal-title":"Circulation"},{"issue":"12","key":"2022021419590708700_B22","first-page":"202","article-title":"Lyme carditis\u2013diagnosis, treatment and prognosis","volume":"112","author":"Scheffold","year":"2015","journal-title":"Dtsch Arztebl Int"},{"issue":"8","key":"2022021419590708700_B23","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/j.amjcard.2008.12.027","article-title":"Prospective evaluation of fetuses with autoimmune-associated congenital heart block followed in the PR Interval and Dexamethasone Evaluation (PRIDE) Study","volume":"103","author":"Friedman","year":"2009","journal-title":"Am J Cardiol"},{"issue":"3","key":"2022021419590708700_B24","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.jcrc.2008.10.016","article-title":"The efficacy and dosage effect of corticosteroids for the prevention of atrial fibrillation after cardiac surgery: a systematic review","volume":"24","author":"Marik","year":"2009","journal-title":"J Crit Care"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2020-009738\/1261394\/peds_2020009738.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2020-009738\/1261394\/peds_2020009738.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T19:59:36Z","timestamp":1644868776000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/146\/6\/e2020009738\/33550\/MIS-C-and-Cardiac-Conduction-Abnormalities"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,1]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2020-009738","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,1]]},"article-number":"e2020009738"}}