About the disease
Atrioventricular blocκ is abbreviation for AVB, which is a block of the heart. If a patient has atrioventricular heart block, it means that there are abnormalities of electrical impulses from the area of atria to the ventricles. Patients with atrioventricular heart block often experience disruption of heart rhythm and hemodynamics.
Causes:
- Intense exercise when heart rhythm quickens many times per day
- Overuse of certain anti-arrhythmic drugs (beta-blockers, antidepressants)
- Heart diseases, which affect atrioventricular connection of heart
Nevertheless, real causes of AVB are still unknown, because doctors can not determine the exact reason why the electrical impulses become dysfunctional. Usually the beta-blockers do not disrupt the electrical impulses if a person`s heart is healthy, that is why there is an assumption that most patients with atrioventricular block have genetical predisposition.
There are three stages of atrioventricular heart block. The first one is not very dangerous and very often a person does not need to undergo any treatment. Nevertheless, patients with 1st degree atrioventricular block need to be examined by cardiologist on a regular basis. The second degree manifests itself in sudden weakness, blackouts and disruptions of heart. Patients with atrioventricular heart block of this degree may even lose consciousness, but it happens only of the electrical impulses affected lower chambers of the heart. The third stage is called complete atrioventricular block. Complete atrioventricular block is the most dangerous and perilous kind of all bradyarrhythmias and it can result in an unexpected cardiac arrest. Third degree atrioventricular block is usually treated during the surgery.
Symptoms
- Dizziness
- Nausea
- Pain in the heart or in the chest
- Brachycardia
- Disruption of the heart rhythm
Diagnosis
Diagnosis is usually based on the electrocardiogram. Sometimes the doctors conduct a Holter monitoring during which they monitor a heart for 24 hours to understand the nature of electrical impulses. It may be also detected during general examination, so usually the diagnosis of this disease does not present any difficulties.
Treatment
If the cause of atrioventricular block are anti-arrhythmic drugs and b-blockers, they must be cancelled immediately. If atrioventricular block developed after some serious heart disease, a person is required to wear a portable pacemaker. Sometimes it is absolutely necessary to install the pacemaker.
- Permanent pacemakers are not recommended for patients with atrioventricular block of I degree. Usually the treatment of atrioventricular block depends on the degree of the disease. As it was mentioned above, patients with the first degree require only long-term monitoring at the cardiologist and sometimes they are also prescribed with medication, that can quicken the heart rate, because usually patients with atrioventricular block have brachicardia. During the second or third degree pacemaker may be implanted for some period of time, but in most cases it is worn for the rest of the patient`s life because of the possible complications in future. People, who had atrioventricular block once, are always in a danger of myocardial infarction and the pacemaker in most cases can prevent it with the 70-80% certainty. There may be some complications after a long-term use of pacemaker, like infection and its malfunction, but such complications are extremely rare. People, who have third degree of atrioventricular block, are also required to wear the pacemaker, but their condition is more dangerous, that is why in some cases a patient needs to undergo the surgery. Also people who have atrioventricular block need not to lift any weights which are more than 4 kg, because the heart rhythm may become disturbed. They also should avoid any stressful situations.
- For type Mobitz 2 and 3 patients are often recommended to combine pacemaker implantation and coronary angiography, during which surgeons repair the coronary artery and them implant the pacemaker.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed
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