Cardiology: Atrioventricular block (AV-Block) — Type Mobitz 2 and 3 — Pacemaker implantation. Treatment
Atrioventricular block is a violation in the cardiac conduction system upon which the passage of electrical impulses from the atria to the ventricles slows or stops. This abnormality prevails among patients already suffering from any cardiovascular disease. The atrioventricular block is treated only in the presence of its manifestations.
Classification and Causes
According to severity of violations, there are 3 degrees of pathology:
- Degree I. The pulse transfer is slowing, but not interrupted. Clinically, this form is not recognized and does not require treatment, but over time can develop into a block of a higher degree. The usual cause of this condition is inflammatory diseases of the myocardium, or administration of certain cardiovascular drugs.
- Degree II. The pulses are not conducted periodically. This pathology often results from poisoning by drugs, congenital heart disease, and certain autoimmune diseases. Like degree I block, this form can be transformed into a full block.
- Degree III. The pulses are not conducted at all. As a result, the atria and the ventricles begin to contract independently from each other. The disease can be caused by structural abnormalities of the heart, myocardium inflammation or autoimmune conflict.
The clinical picture of atrioventricular block is very diverse and ranges from asymptomatic forms to development of severe conditions. The complaints may include:
- bouts of severe weakness,
- chest pain,
- occasionally perceived "fading" of the heart,
- episodes of bradycardia (slow heart rate).
The diagnosis is confirmed on the basis of clinical examination and ECG findings. To assess the severity of the disease and identify its causes, the following tests are further prescribed:
- ECG monitoring,
- heart MRI.
Patients with asymptomatic forms of block do not need treatment, however, must be monitored by a cardiologist regularly.
In other cases, the treatment tactics depends on the cause of disease:
- the toxic effects of drugs are corrected by their withdrawal or dose reduction,
- organic heart disease and heart failure are treated with drugs.
For life-threatening conditions, the patients are recommended to have a pacemaker installed.Hide
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