Atrioventricular Block

Heart block is a condition that affects the electrical system that controls the heartbeat. Atrioventricular block is defined as a delay or interruption in the transmission of an impulse from the atria to the ventricles due to an anatomical or functional impairment. Mild types of heart block can cause your heart to beat more slowly or to skip beats.

How common is atrioventricular block?

This health condition is quite common. It often affects people with a disease, surgery, or medicine that damage the heart. In rare cases, people are born with heart block. Moreover, the third degree of atrioventricular block is more likely happens in women.

It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

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As any abnormalities in heart block, atrioventricular block happens when the transmission function of heart conducing system is either get slow down or stopped according to various following etiologies.

People who have heart disease are more likely to get heart block. It sometimes can be considered as iatrogenic and may be transmitted as an autosomal dominant trait.

Common risk factors of heart disease:

  • Age: more common in older people
  • People who have a history of heart disease or heart attacks are at increased risk for heart block. Examples of heart disease that can lead to heart block include heart failure, coronary heart disease, and cardiomyopathy (heart muscle diseases).
  • Lack of exercise
  • Access fat (abdominal or central obesity)
  • Family-related venous diseases (early onset)
  • Smoking
  • Impair peripheral artery
  • Preeclampsia
  • Kidney disease (especially chronic kidney failure)
  • Medications: A variety of drug, including of digitalis, calcium channel blockers (especially verapamil and diltiazem), amiodarone, adenosine, and beta-blockers, can impair AV conduction.

Signs and symptoms of atrioventricular block include the following:

  • First-degree AV block: Generally not associated with any symptoms; it is usually an incidental finding on electrocardiography
  • Second-degree AV block: Usually is asymptomatic, but in some patients, sensed irregularities of the heartbeat, presyncope, or syncope may occur; may manifest on physical examination as bradycardia (especially Mobitz II) and/or irregularity of heart rate (especially Mobitz I [Wenckebach])
  • Third-degree AV block: Frequently associated with symptoms such as fatigue, dizziness, light-headedness, presyncope, and syncope; associated with profound bradycardia unless the site of the block is located in the proximal portion of the atrioventricular node (AVN)

In third-degree AV block, exacerbation of ischemic heart disease or congestive heart failure caused by AV block–related bradycardia and reduced cardiac output may lead to specific, clinically recognizable symptoms, such as the following:

  • Chest pain
  • Dyspnea
  • Confusion
  • Pulmonary edema

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

Doctors will check your physical symptoms and your history of heart diseases, as well as your family history.

Your doctor may ask whether:

  • You have any signs or symptoms of heart block
  • You have any health problems, such as heart disease
  • Any of your family members have been diagnosed with heart block or other health problems
  • You’re taking any medicines, including herbal products and prescription and over-the-counter medicines
  • You smoke or use alcohol or drugs

Afterward, some tests might be carried out in order to confirm the diagnosis:

  • EKG (Electrocardiogram): EKG shows how fast the heart is beating and its rhythm (steady or irregular).
  • Holter and event monitors: A Holter monitor records the heart’s electrical signals for a full 24- or 48-hour period. You wear one while you do your normal daily activities.
  • Electrophysiology study: Doctors may do electrophysiology studies (EPS). During this test, a thin, flexible wire is passed through a vein in your groin (upper thigh) or arm to your heart.

Treatment depends on the type of heart block you have. If you have first-degree heart block, you may not need treatment.

If you have second-degree heart block, you may need a pacemaker. A pacemaker is a small device that’s placed under the skin of your chest or abdomen. This device uses electrical pulses to prompt the heart to beat at a normal rate.

If you have third-degree heart block, you will need a pacemaker. In an emergency, a temporary pacemaker might be used until you can get a long-term device. Most people who have third-degree heart block need pacemakers for the rest of their lives.

Some people who have third-degree congenital heart block don’t need pacemakers for many years. Others may need pacemakers at a young age or during infancy.

If a pregnant woman has an autoimmune disease, such as lupus, her fetus is at risk for heart block. If heart block is detected in a fetus, the mother might be given medicine to reduce the fetus’ risk of developing serious heart block.

Sometimes acquired heart block goes away if the factor causing it is treated or resolved. For example, heart block that occurs after a heart attack or surgery may go away during recovery.

Also, if a medicine is causing heart block, the condition may go away if the medicine is stopped or the dosage is lowered. (Always talk with your doctor before you change the way you take your medicines.)

The following lifestyles and home remedies might help you cope with atrioventricular block:

  • Eating a healthy diet. This involves eating a lot of fruits and vegetables and low-fat dairy products, but not a lot of meat of fatty food.
  • Walking or doing a physical activity on most days of the week.
  • Losing weight, if you are overweight.

If you have any questions, please consult with your doctor to better understand the best solution for you.

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