Editorial commentary: Live better electrically? Optimizing the timing and application of pacing in congenital heart block

[...]the risk of isolated (presumed) autoimmune congenital heart block [5] in the older infant and child are low, and management is predominantly aimed at the prevention of syncope, which can usually be predicted based on a low mean heart rate (typically 3 s or multiples of the junctional escape interval; ie: junctional exit block). In keeping with the message of the current review article, children affected with CCHB should receive a pacing system prior to entering adulthood, so as to avoid the morbidity and occasional mortality associated with Stokes Adams attacks in this age group and reduce the potential for development of acquired mitral insufficiency [14]. In summary [16], the optimal management of CCHB [17] requires appropriate recognition in the affected fetus (allowing for optimal management and timing of delivery), appropriate timing, approach and mode of pacing, ongoing surveillance for complications, and further research into the markers and mechanisms of disease with a view to primary prevention.