Treatment Atrioventricular block (av-block) abroad

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.

Atrioventricular heart block causes

  1.  intense exercise when heart rhythm quickens many times per day
  2.  overuse of certain anti-arrhythmic drugs (beta-blockers, antidepressants)
  3.  heart diseases, which affect atrioventricular connection of heart

Nevertheless, real causes of atrioventricular block 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.  

In case of the atrioventricular heart block the electrical impulse from the atria to the ventricles occurs more slowly than usual. If person has an atrioventricular heart block, he is not allowed to take drugs that slow and lower heart rate. Usually such drugs are prescribed when the patient has brachicardia or any other heart disease which causes the heart rhythm to somehow change. Most popular drugs that slow the heart rate are beta-blockers and they are prescribed most often for treatment of heart diseases.

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.

  Atrioventricular block symptoms

  1.  dizziness
  2. nausea
  3. pain in the heart or in the chest
  4. brachycardia
  5. disruption of the heart rhythm

Atrioventricular block 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.

Atrioventricular block 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. Patients must wear a pacemaker if they have or had:

  1. attacks of Morgagni-Adams-Stokes
  2. atrioventricular block of II or III degree.
  3. symptomatic bradycardia
  4. myocardial infarction
  5. ischemia

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.        

Atrioventricular block prognosis

The prognosis of AV block is determined primarily by the stage of the disease and by its etiology and, to a lesser extent, by the degree of block. Mortality for patients with atrioventricular block varies from 30% and 80%. There is such a big difference on the percentage, because some patients have less dangerous type of atrioventricular block. If the atrioventricular block affected myocardial muscle or if the patient had attack of Morgagni - Adams - Stokes, the prognosis becomes worse. The prognosis for patients with atrioventricular blockade also worsens if they have ventricular arrhythmia, because in that way they can develop ischemia in future.

Atrioventricular block prevention

There are no special preventive methods for atrioventricular block.The main method of preventing the development of  atrioventricular block is the installation of the pacemaker. Also patients who have atrioventricular block are required to quit smoking and to lead healthy lifestyle. They are not recommended to consume a big amount of salt and usually people with this disease need to go on a diet which restricts any consumption of the salt. They are also not recommended to eat spicy or pickled food and to drink alcohol. The only alcohol which is allowed is red wine. Cardio exercises which include jogging, rope jumping and cycling need also to be avoided, at least during the first stages of treatment.   

Atrioventricular block complications

The biggest complication of atrioventricular block is the attack of Morgagni-Adams-Stokes. It may also cause arrhythmia and ventricular tachycardia. Attack of Morgagni-Adams-Stokes usually occurs during the second or third degree of atrioventricular block. During the third degree it can have such complication cardiogenic shock or acute myocardial infarction. Myocardial infarction is very dangerous, because it can result cardiac death. People who have atrioventricular block and who are not treated timely, can also have mental disorders.

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