Heart block is classified by how much the electrical signals between the atria and the ventricles are slowed down. There are three types of heart block:. Heart block can occur at any age, but it is most likely to occur in the elderly — especially people who have other forms of heart disease such as:.
Some medications — including digoxin , beta-blockers and calcium channel blockers — may cause heart block. If you take any of these medications, your healthcare team will watch you closely for signs of heart block.
Trained athletes and young people with a high vagal tone may also have first-degree heart block. There is one vagus nerve running from your brain to your abdomen on each side of your body. Vagus nerve activity slows the heart rate. Symptoms of second-degree or third-degree heart block range from lightheadedness to fatigue or fainting, shortness of breath and chest pain.
Sometimes a pacemaker is implanted to treat second and third-degree heart block. The pacemaker takes over the job of regular electrical stimulation of the heart. It will help your heart to beat in a regular rhythm. First-degree heart block involves minor heartbeat disruptions, such as skipped beats. It is the least serious type of heart block, and it does not generally require treatment. Second-degree heart block occurs when some electrical signals never reach the heart, causing dropped or skipped beats.
The patient may feel dizzy, and they may need a pacemaker. The ventricle may not contract, as the atrial impulse did not reach the ventricles. Third-degree or complete heart block is when electrical signals do not travel between the upper and lower chambers of the heart. It is more common in patients with heart disease. Without a pacemaker, there is a serious risk of heart attack. In a healthy heart, electrical impulses that travel inside a heart muscle instruct it to contract, or beat.
The impulses move along a pathway, from the upper heart chambers, through the atrioventricular AV node, to the lower chambers. Along this pathway is a cluster of cardiac fibers. The bundles conduct the electrical impulses to the heart ventricles.
Each ventricle has a branch. Damage to one of the branch bundles can cause uncoordinated ventricular contractions, and an abnormal heart beat can result. A blocked signal on the right side of the heart is not usually serious, but a block on the left side can indicate a higher risk of coronary artery disease, or some other heart problem.
The most common cause of heart block is scarring of the heart tissue as people get older. Some people are born with heart block, but older people with a history of heart disease or smoking are most at risk. Acute, or sudden, heart block may also occur after a heart attack or a heart operation.
It can also occur as a complication of Lyme disease. A physician will discuss symptoms with the patient and listen to their heart. Depending on age and medical history, the doctor may suspect heart disease, and will refer the patient to a cardiologist, or a heart specialist.
An electrocardiogram ECG is the most common test. An electrophysiology study, which is an outpatient procedure in which a thin, flexible wire is threaded from your groin or arm to your heart to test the heart's wiring system. How is heart block treated?
You treatment depends on the type of heart block you have: With first-degree heart block, you might not need treatment. With second-degree heart block, you may need a pacemaker if symptoms are present or if Mobitz II heart block is seen. With third-degree heart block, you will most likely need a pacemaker. In addition, your medical team may make changes in any medicines you're taking.
What are the complications of heart block? Can heart block be prevented? To improve your quality of life with a pacemaker, you may need to: Avoid situations in which your pacemaker may be disrupted, such as being near an electrical device or devices with strong magnetic fields. Carry a card that lets people know what kind of pacemaker you have.
Tell all of your healthcare providers that you have a pacemaker. Get routine pacemaker checks to make sure your device is working well Stay active, but avoid contact sports. Wear a medical alert bracelet or necklace. When should I call my healthcare provider? Seek immediate medical attention for these symptoms: Extreme tiredness Dizziness Fainting or loss of consciousness Shortness of breath Chest pain If you have sudden cardiac arrest, you will obviously not be able to seek care for yourself.
There are three degrees of heart block. First degree heart block may cause minimal problems, however third degree heart block can be life-threatening. Heart block may cause no symptoms or it may cause dizziness, fainting, the feeling of skipped heart beats, chest pain, difficulty breathing, fatigue, or even cardiac arrest Depending on your degree of heart block, you may not need treatment, but for some, a pacemaker is advised. Next steps Tips to help you get the most from a visit to your healthcare provider: Know the reason for your visit and what you want to happen.
But more commonly, heart block develops later in life. This is known as acquired heart block and can be caused by:. Babies are more likely to have congenital heart block if they're born with a heart defect, or if their mother has an autoimmune condition, such as lupus. Heart block normally only needs to be treated if it's causing symptoms. Depending on the cause of heart block and your symptoms, you may need to have a small device called a pacemaker fitted in your chest.
A pacemaker is a small battery-operated device inserted under the skin of your chest. It sends frequent electrical pulses to keep your heart beating regularly. Read more about how a pacemaker is fitted. Treatment for heart block usually works well. Most people live a normal active life with a pacemaker.
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