Anaesthetic management of a parturient with complete heart block for emergency caesarean section

Management of patient with complete heart block (CHB) presenting for emergency caesarean section warrants preservation of heart rate to maintain haemodynamic stability. Sudden cardiac death and congestive heart failure are known sequelae because of slow heart rate caused by complete heart block. Role of temporary pacing is debatable for labor and delivery in asymptomatic patients. However in absence of pacemaker, Isoprenaline with general anaesthesia can be safely employed when chronotropic response to atropine is observed in these patients.