Atrioventricular Block (av-block) - Best Hospitals, Doctors, Prices - Booking Health

Treatment of Atrioventricular Block (av-block)

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Best hospitals and doctors for atrioventricular block (av-block) treatment abroad

Leading hospitals

Cost for treatment

AV-Block Diagnosis
Atrioventricular block diagnosis and conservative treatment
Pacemaker implantation and coronary angiography to treat AV block Type Mobitz
Pacemaker implantation to treat AV block Type Mobitz 2 and 3
Cardiac rehabilitation
The St. Vincentius Hospital Karlsruhe is a modern medical facility with a rich history and traditions. The medical complex is an academic hospital of the University of Freiburg, granting patients access to advanced university medicine and the very latest therapeutic developments. The hospital first opened its doors in 1851 and,
University Hospital Ulm

University Hospital Ulm

Overall rating8.7 / 10
The University Hospital Ulm is an advanced medical complex that provides patients with high-class medical care using the very latest scientific achievements. The medical facility has been performing successful clinical activities for more than 40 years and has long earned an excellent reputation throughout Europe. The hospital r
According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
According to Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all fields of
According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
University Hospital Jena

University Hospital Jena

Overall rating8.9 / 10
According to the prestigious Focus magazine, the University Hospital Jena regularly ranks among the top German medical facilities! The hospital has positioned itself as a multidisciplinary medical facility with a long history of more than 200 years. Since its foundation, the hospital has been constantly developing and modernizin
According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
According to the authoritative Focus magazine, the University Hospital Duesseldorf ranks among the top Germany hospitals! The hospital is an excellent example of a combination of high-quality health care, research and teaching activities. With more than 50,000 inpatients and about 300,000 outpatients every year, the hospital is
According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
The University Hospital Rechts der Isar Munich was founded in 1834. It combines long traditions with the very latest advances in modern medicine. The medical facility includes 33 specialized departments and 20 interdisciplinary centers, where patients can receive top-class medical care in all medical fields. The hospital annuall
University Hospital Bonn

University Hospital Bonn

Overall rating9.2 / 10
According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
According to the Focus magazine, the University Hospital Muenster ranks among the top German hospitals! The hospital belongs to the most prestigious medical institutions in Germany. The hospital is distinguished by a high professionalism of its doctors, state-of-the-art technological equipment and the availability of the most ad
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Atrioventricular block is the most common type of cardiac conduction disorder. The initial degrees of AV block are detected in many children, young people and athletes. They are not dangerous and do not require treatment, but severe blocks pose a health threat: they lead to bradycardia, cause fainting, and can become a cause of sudden cardiac death. The treatment of atrioventricular block abroad involves the use of permanent cardiac pacing.


  1. What is AV heart block
  2. Symptoms
  3. Is atrioventricular block dangerous
  4. Treatment principles
  5. Indications for pacemaker implantation
  6. How is the pacemaker implanted
  7. Why is it worth undergoing treatment abroad
  8. Treatment in Europe at an affordable price

What is AV heart block 


For the heart to contract, electrical impulses must travel through the myocardium (heart muscle). They are generated by the sinus node located in the right atrium, from which the impulse spreads throughout the heart. However, the block of the cardiac conduction system disrupts the conduction of the impulse from the atria to the ventricles.

This condition is called atrioventricular (AV) block. The disease can have three degrees of severity:

  • 1st degree heart block – all impulses reach the ventricles, but they travel slower than usual.
  • 2nd degree – some of the impulses do not reach the ventricles. 
  • 3rd degree – not a single impulse reaches the ventricles of the heart.

Even with a complete block, the heart does not stop, as reserve pacemakers are activated, but they provide a lower pulse rate. The ventricles contract more slowly, so the blood supply to the brain is impaired.



Symptoms are one of the main indications for surgical treatment of AV block. Due to a slowdown in the heart rate, a person feels fatigue, suffers from dizziness, and experiences a reduced exercise tolerance. The more severe the block, the worse the person tolerates stress, since against the background of physical work, the tissue demand for oxygen increases, and the heart does not contract quickly enough to provide it.

The severe block contributes to the development of Morgagni-Adams-Stokes syndrome. Periodically, the heart rate decreases so much that the brain receives less oxygen and "turns off". A person loses consciousness, and may suffer from convulsions, involuntary defecation and urination. The presence of such attacks significantly increases the risk of sudden cardiac death.

Is atrioventricular block dangerous


In most cases, 1st and 2nd degree AV blocks are not dangerous. The condition does not progress, does not significantly affect the pulse rate, does not impair hemodynamics. Such patients do not need treatment. They do not experience any symptoms and do not suffer from complications.

Sometimes even 1st degree AV block may lead to adverse consequences. Although with this type of heart block all impulses travel from the atria to the ventricles, sometimes it takes too much time. The form of pathology is considered unfavorable when the PQ interval is increased to 0.3 seconds. On the cardiogram, this interval reflects the time of the impulse travel from the atria to the ventricles. In this case, even with 1st degree heart block, the patient may need the treatment of AV block.

This unfavorable form rarely develops as a result of diseases. It usually occurs as a complication of a medical procedure: ablation of the fast path of impulses. The procedure is performed for AVRT (atrioventricular reentrant tachycardia). In this heart disease, the conducting beam is divided into two, and therefore heartbeats occur due to the circulation of impulses. Nonetheless, when a fast beam is destroyed, a slow one remains, which conducts electrical impulses for too long.

An unfavorable form of even the early degrees of AV block (type 1 first-degree and second-degree) can lead to long-term consequences:

  • Deterioration of exercise capacity. 
  • Left ventricular dilatation, dilated cardiomyopathy. 
  • Heart failure. 

However, in most cases, patients with the early stages of AV block do not suffer from symptoms and do not require treatment. The therapy is mostly provided to patients with type 2 second-degree AV block or patients with complete AV block (third-degree). Such patients have severe and life-threatening complications. These are as follows:

  • Morgagni-Adams-Stokes syndrome (it is manifested by loss of consciousness due to oxygen starvation of the brain, sudden cardiac death is possible as well).
  • Atrial fibrillation, which provokes the formation of blood clots in the heart chamber, increases the risk of thromboembolic complications (for example, ischemic stroke). 
  • Ventricular fibrillation is a severe arrhythmia that is fatal without emergency help. 

Treatment principles 


The causes of AV block can be reversible and irreversible. 

In case of reversible causes, drug therapy or temporary cardiac pacing can be used. At the same time, doctors provide the treatment aimed at eliminating the block, or simply wait until it disappears by itself, for example, an AV block develops and then disappears early after heart surgery.

In case of irreversible causes, neither drug therapy nor monitoring usually makes sense. AV block is associated with damage to the cardiac conduction system, and it cannot be restored. Drug treatment is used only for the relief of emergency conditions, for example, a Morgagni-Adams-Stokes attack. To obtain long-term results, the pacemaker implantation is required.

Treatment goals: 

  • Symptom relief. 
  • Improved exercise tolerance.
  • Reduced risk of sudden cardiac death. 

The principle of treatment is based on the implantation of a device that imposes its own rhythm on the heart. It does not work constantly, but gives impulses only in those cases when the frequency of contractions becomes low or the pauses of the rhythm are too long.

Indications for pacemaker implantation 


In some cases, implantation of a pacemaker is vital. In other situations, the issue is discussed with the patient. When making a decision, doctors take into account the presence of symptoms, age, lifestyle (level of physical activity).

During the diagnostics, it is determined whether the block is reversible or irreversible, permanent or occurs periodically, whether the risk of progression is high or low, whether slip rhythms appear from the pacemakers of the lower level, especially those located below the atrioventricular node. Consideration is given to the heart rate, block level, type and severity of heart disease.

Pacemaker implantation is recommended for patients with the following conditions: 

  • Permanent complete or type 2 second-degree atrioventricular block.
  • Recurrent severe block, if the patient has an enlarged heart, heart failure and other concomitant pathologies.
  • Rhythm pauses for more than 3-5 seconds.
  • Heart rate less than 40 per minute during the day or less than 35 per minute during a night's sleep.
  • Rhythms appear from pacemakers below the level of the AV node.
  • Manifestation of symptoms at rest.
  • Symptoms arising during exercise that are not associated with myocardial ischemia.
  • According to the electrophysiological study, the block is at the level of the atrioventricular node or below.

One of the decisive factors in choosing the tactics of patient treatment is the presence of symptoms, the interconnection of which with AV block has been proven. With the presence of symptoms, a pacemaker can be implanted even for cardiac conduction disturbances of low severity. To prove the interconnection of symptoms with the block, a long-term monitoring of the rhythm is carried out. The episodes of weakness, dizziness, darkening of the eyes, etc. should coincide in time with a decreased heart rate.

In addition, heart failure can be the reason for pacemaker implantation. With the concomitant AV block, the heart beats more slowly. In a healthy person, this would not lead to symptoms, but heart failure contributes to the decreased effectiveness of hemodynamics. After implanting a pacemaker, the patient's heart rate increases, which results in more efficient circulation, fewer symptoms, and better quality of life.

How is the pacemaker implanted 


The pacemaker implantation is a minimally invasive surgery that does not require general anesthesia. A person does not even need to stay in the hospital. All manipulations are performed under local anesthesia.

The doctor makes an incision in the skin of the chest up to 5 cm long, and implants the body of the pacemaker under the skin. The pacemaker leads are inserted into the heart through the blood vessels.

Pacing modes for the treatment of atrioventricular block can be as follows: 

  • Dual-chamber pacing. 
  • Single-chamber ventricular pacing. 
  • Single-chamber P-synchronous pacing. 

The standard option is dual-chamber pacing. One pacemaker lead is inserted into the right atrium, while the other into the right ventricle. This therapy is synchronizing. The device can send impulses to both the atria and the ventricles, thereby ensuring a consistent contraction of the chambers of the heart.

Occasionally, single-chamber ventricular pacing can be used. Such a pacemaker is cheaper, but it does not provide synchronous contraction of the atria and ventricles. There is no pacemaker lead in the atrium, so they contract in a normal rhythm. The pacemaker lead will only stimulate the contraction of the ventricles if they become too infrequent. The method of pacing is used in patients with chronic atrial fibrillation or in other situations when the atria do not contract rhythmically.

Another treatment option for AV block is single-chamber P-synchronous cardiac pacing. Doctors can conduct pacing of only the ventricles, but the activity of the atria is monitored, and therefore the contractions of the heart chambers are synchronized. This type of pacing is possible only in patients with normal sinus node function, that is, with a sufficiently high frequency of atrial contraction, when only the ventricles need to be paced.

Why is it worth undergoing treatment abroad 


Many patients with heart block travel abroad for treatment. Doctors in Europe implant the latest pacemakers that do not damage the heart muscle even with prolonged use, provide a minimum risk of complications, and have a function of frequency adaptation: the ability to increase the heart rate against the background of physical activity.

There are several reasons for you to undergo treatment of AV block abroad: 

  • High-precision diagnostics aimed not only at establishing the type of heart block and its severity, but also at determining the cause of the pathology.
  • Whenever possible, treatment is aimed at eliminating the cause of the block so that the patient does not have to undergo pacemaker implantation.
  • Minimally invasive, very accurate, and safe placement of a pacemaker.
  • The use of the latest models of these devices, which are reliable and multifunctional.
  • Individual selection of the pacing mode and fine tuning of the device.
  • The possibility of simultaneous treatment of several heart diseases at once: 50% of patients with heart block have myocardial ischemia, 25% have arterial hypertension, and 10% have heart defects.

The patients with severe arrhythmias who undergo treatment abroad can count on high-quality and safe medical care. Even with the worst types of heart block, the heart rate can be raised to normal levels, thus completely relieving symptoms and preventing dangerous complications.

Treatment in Europe at an affordable price 


To undergo treatment in one of the European hospitals, please use the services of the Booking Health company. On our website, you can find out the cost of treatment in Europe and compare prices in order to book a medical care program at a favorable price. The treatment in Europe will be easier and faster for you, and the cost of treatment will be lower.

You are welcome to leave your request on the Booking Health website. Our specialist will contact you and provide a free consultation on medical treatment in Europe. Booking Health will take care of the organization of your trip abroad. We will provide the following benefits for you:

  • We will select a hospital for treatment in Europe, whose doctors specialize in the treatment of atrioventricular block and achieve the best results.
  • We will solve the problem of the language barrier and help to establish communication with your attending physician.
  • We will reduce the waiting time for the medical care program. You will undergo treatment on the most suitable dates.
  • We will reduce the price. The cost of treatment in European hospitals will be reduced due to the lack of overpricing and additional coefficients for foreign patients.
  • We will help you to solve any organizational issues: we will draw up documents, meet you abroad and take you to the hospital, book a hotel, and provide interpreting services.
  • We will prepare a program and translate medical documents. You will not need to repeat the previously performed diagnostic procedures.
  • We will help you keep in touch with the hospital after treatment in Europe.
  • We will arrange additional diagnostic examinations and treatment in European hospitals, if required.
  • We will buy medicines in another country and forward them to your native country. 

The world's leading doctors will take care of your health. The Booking Health specialists will help reduce the cost of treatment, organize your trip, and you can fully focus on restoring your health.

Authors: Dr. Nadezhda IvanisovaDr. Farrukh Ahmed

To check for the Atrioventricular block (av-block) you can submit a request on BookingHealth and our managers will find the best hospital that is specialized in Atrioventricular block (av-block) to fulfill your needs
Cost of Atrioventricular block (av-block) treatment varies from 4055.94 to 27853.46