Heart Block Types Causes Symptoms Treatment
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rarediseases.org/rare-diseases/heart-block-congenital/Getting more exercise than guidelines suggest may further lower death risk. (2022).
heart.org/en/news/2022/07/25/getting-more-exercise-than-guidelines-suggest-may-further-lower-death-riskJo-Nan L. (2016). Long-term outcome in patients receiving permanent pacemaker implantation for atrioventricular block.
journals.lww.com/md-journal/fulltext/2016/08300/Long_term_outcome_in_patients_receiving_permanent.49.aspxKerola T, et al. (2019). Risk factors associated with atrioventricular block.
jamanetwork.com/journals/jamanetworkopen/fullarticle/2734061Knabben V, et al. (2022). Third-degree atrioventricular block.
ncbi.nlm.nih.gov/books/NBK545199/Mangi MA, et al. (2022). Atrioventricular block second-degree.
ncbi.nlm.nih.gov/books/NBK482359/Mittal S, et al. (2018). Increased healthcare utilization associated with complete atrioventricular block in pacemaker patients.
ncbi.nlm.nih.gov/pmc/articles/PMC5902523/Oldroyd SH, et al. (2022). First-degree heart block.
ncbi.nlm.nih.gov/books/NBK448164/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 24, 2022 By Daniel Yetman Edited By Rosalie Rung Medically Reviewed By Uzochukwu Ibe, MD, MPH Copy Edited By Megan McMorris Share this articleMedically reviewed by Uzochukwu Ibe, MD, MPH — By Daniel Yetman on October 24, 2022
What to Know About Heart Block
Medically reviewed by Uzochukwu Ibe, MD, MPH — By Daniel Yetman on October 24, 2022Heart block is a disruption in the electrical signals that control your heart. Your heart depends on a steady flow of electrical signals that start in the heart’s upper chambers (atria). The signals then travel down the lower heart chambers (ventricles), triggering the ventricles to pump blood out of the heart into the lungs and to the rest of the body. Heart block occurs when there’s an interference with this electrical activity between the atria and ventricles. A heart block is often the result of a heart attack or other injury to the heart, but it can have other causes. If the heart block is minor, treatment may not be necessary. If it’s more severe, a pacemaker may be needed to restore healthy electrical activity in the heart. Read on to learn about the types of heart block, causes, symptoms to watch out for, and common treatments.What are the types of heart block
A heart block, also known as an atrioventricular (AV) block, is classified by degree, based on how severe the electrical blockage is between the upper and lower heart chambers.First degree
In first-degree heart block, electrical signals slow as they move from the upper chambers to the lower chambers of the heart. However, the signals don’t stop, even intermittently. First-degree heart block is more common in adults over the age of 60, affecting an estimated 6% of that population. The prevalence of first-degree heart block in people under age 60 is 1% to 1.5%.Second degree
Second-degree heart block is categorized in two ways: Type I and Type II.Type I: This is also called Mobitz Type I or Wenckebach’s AV block. It’s a less severe form of second-degree heart block and is characterized by gradually slower electrical activity to the point where the heart skips a beat.Type II: Also known as Mobitz Type II, this occurs when an increasing number of electrical signals fail to reach the ventricles. This causes a slower, abnormal rhythm. Type II is most often associated with structural heart diseases, such as myocardial fibrosis, a condition that involves the thickening of heart muscle tissue that’s triggered by hypertension or heart disease.Third degree
Third-degree heart block is more severe than the other types. It means that the electrical signal from the atria is completely blocked from reaching the ventricles. As a result, the ventricles often begin to beat on their own. The heartbeat is much slower and more irregular, making it hard for the heart to pump enough blood to meet the body’s demands. It can result in a very slow pulse or no pulse at all. Third-degree heart block is rare, affecting less than 0.05% of the population.What causes heart block
Heart block is usually the result of a trauma that affects the heart’s electrical system. Your risk of heart block also increases as you get older. Other risk factors include a history of:heart attackheart structure problems, such as hypertrophic cardiomyopathyheart valve diseasehigh potassium levels Several medical conditions may also increase the risk of heart block, including:acute rheumatic fevercardiac tumorshyperthyroidismLyme diseaselymphoma and other malignancies A 2019 study also suggests that two key cardiovascular risk factors — high blood pressure and elevated blood glucose levels — are associated with higher risks of developing heart block. Open-heart surgery may also raise the risk of heart block or other heart rhythm disturbances (arrhythmias). Additionally, heart block can be a side effect of some types of drugs. Medications associated with heart block include:beta-blockerscalcium channel blockersdigoxinfingolimod (for multiple sclerosis) Although rare, heart block can also be a congenital condition, affecting an estimated 1 out of 15,000 to 22,000 live births. In most congenital heart block cases, the mother had an autoimmune disorder, such as lupus or Sjögren’s syndrome.What are the symptoms of heart block
The type and severity of symptoms depends on the type of heart block.First-degree symptoms
Many times, first-degree heart block has no symptoms. An abnormal heart rate and rhythm may be detected during a routine electrocardiogram (ECG).Second-degree symptoms
When symptoms are present in second-degree heart block, they usually include fatigue and lightheadedness, sometimes resulting in fainting (syncope). Other possible symptoms of second-degree heart block include:chest painheart palpitations (feeling as though the heart is skipping a beat)nauseashallow or rapid breathingThird-degree symptoms
Symptoms caused by third-degree heart block are usually more severe and are considered a medical emergency. The most common symptoms include:chest paindizzinessshortness of breathfaintingvery slow pulse or no pulseHow serious is heart block
Heart block is not always serious, but it depends on the type. First-degree and even second-degree heart block (Type I), may be managed with little or no treatment. These types of heart block may have little impact on your long-term health or quality of life. Second-degree (Type II) and third-degree heart block usually need a pacemaker, but with certain lifestyle changes, you may be able to live comfortably for a long time. In rare cases, patients that experience frequent fainting episodes (syncope) due to heart block may also require a pacemaker. One of the most serious risks of heart block is heart failure. A 2018 study suggests that in cases of complete heart block, there is a significantly higher risk of heart failure. Third-degree heart block can also cause damage to internal organs and cardiac arrest (no heartbeat).How is heart block diagnosed
A comprehensive evaluation of your heart health should include a physical exam in which your doctor listens to your heart with a stethoscope. They should also review your personal and family medical history, medications and supplements you’re taking, and your symptoms. First-degree heart block, and some cases of second-degree heart block, are often detected through a routine physical exam and ECG. An ECG is a noninvasive test that uses electrodes to measure your heart’s rhythm, rate, and strength, as well as the pattern of your heart’s electrical activity. For intermittent electrical abnormalities, you may be advised to wear a portable ECG monitor, such as a Holter monitor, for 24 hours or more. In rare cases, your doctor may also order an electrophysiology study, which involves placing a catheter into a blood vessel. The catheter is then guided to the heart to monitor the heart’s electrical activity.How is heart block treated
Most cases of first-degree heart block don’t require any treatment. However, with some types of second-degree heart block as well as third-degree heart block, a pacemaker is usually necessary. A pacemaker is a small battery-powered device surgically implanted in the chest. It senses when the heart is beating abnormally and sends mild electrical charges to the heart to restore a healthy heartbeat. A study of pacemakers to treat heart block suggests that both dual-chamber pacing (which involves sending signals to both the upper and lower heart chambers) and synchronous ventricular pacing (which only stimulates the lower chamber) are both effective long-term solutions for heart block. However, having heart failure or other serious medical conditions can affect long-term effectiveness.Can heart block be prevented
Heart block can’t always be prevented. Because it’s often a complication of heart disease, the best way of lowering your risk is to follow a heart-healthy lifestyle that includes:eating a heart-healthy diet, such as the Mediterranean dietexercising regularly, aiming for at least 150 minutes a week of moderate-intensity aerobic activitynot smokingmanaging your weightmanaging stress in a healthy way, including getting 7 to 9 hours of sleep each nightgetting regular check-ups with your doctorThe bottom line
Heart block is the disruption of the electrical energy flow from your heart’s upper chambers (atria) to the lower chambers (ventricles). If it’s a minor disruption, you may not need treatment. However, if the heart block is more severe, you may need a pacemaker to maintain healthy heart function. While heart block can’t always be prevented — age and heart disease are the most common risk factors — a heart-healthy lifestyle that reduces the risk of heart attack and cardiovascular disease may help lower the odds of developing this condition. Last medically reviewed on October 24, 2022How we vetted this article
SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Congenital heart block. (2020).rarediseases.org/rare-diseases/heart-block-congenital/Getting more exercise than guidelines suggest may further lower death risk. (2022).
heart.org/en/news/2022/07/25/getting-more-exercise-than-guidelines-suggest-may-further-lower-death-riskJo-Nan L. (2016). Long-term outcome in patients receiving permanent pacemaker implantation for atrioventricular block.
journals.lww.com/md-journal/fulltext/2016/08300/Long_term_outcome_in_patients_receiving_permanent.49.aspxKerola T, et al. (2019). Risk factors associated with atrioventricular block.
jamanetwork.com/journals/jamanetworkopen/fullarticle/2734061Knabben V, et al. (2022). Third-degree atrioventricular block.
ncbi.nlm.nih.gov/books/NBK545199/Mangi MA, et al. (2022). Atrioventricular block second-degree.
ncbi.nlm.nih.gov/books/NBK482359/Mittal S, et al. (2018). Increased healthcare utilization associated with complete atrioventricular block in pacemaker patients.
ncbi.nlm.nih.gov/pmc/articles/PMC5902523/Oldroyd SH, et al. (2022). First-degree heart block.
ncbi.nlm.nih.gov/books/NBK448164/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 24, 2022 By Daniel Yetman Edited By Rosalie Rung Medically Reviewed By Uzochukwu Ibe, MD, MPH Copy Edited By Megan McMorris Share this articleMedically reviewed by Uzochukwu Ibe, MD, MPH — By Daniel Yetman on October 24, 2022