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Second degree AV block


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  • Second degree AV block

    Has anyone been diagnosed with second degree AV block? Ever since I had my ICD replaced last October I haven't felt quite right and the past few weeks have been unbearable. Anything I do that require minimal upper body strength causes my heart to block and my pulse drops to 60 bpm when it should be over 100 bpm. My docs said there was anything wrong with my heart (besides the HCM) but it is probably caused by a overstimulated vagal nerve running past the heart.

    I had never really heard of this so I was wondering if anyone else had.

  • #2
    I haven't heard of this, but I'm not a nurse or doctor. I hope someone here can help you.


    Husband has HCM.
    3 kids - ages 23, 21, & 19. All presently clear of HCM.


    • #3
      I have an AV-Block but i guess it is just a first degree, have they started pacing ? I was paced for a year it wasn't because of that they were trying to reduce the obstruction i had and then i had a myectomy and was told i had the AV-Block and then during another test was told i had a LBBB so who knows

      Good Luck and be WELL

      Diagnosed 2003
      Myectomy 2-23-2004
      Husband: Ken
      Son: John diagnosed 2004
      Daughter: Janet (free of HCM)

      Grandchildren: Drew 15,Aaron 13,Karen 9,Connor 9


      • #4
        Darek, there are several types of AV Block. 1st degree AV block is usu a watch and be aware of type thing, usu isn't treated, may be due to meds

        There are 2 types of 2nd degree AV Block - Type I and Type II. Treatment plan depends on the type you have and the cause of it.

        3rd degree AV Block requires a pacemaker for backup safety.

        Blocks can certainly go along with HCM, so "nothing wrong" but HCM isn't much of an explanation. Call your doc, make sure he knows how bad you are feeling. Ask for a better explanation of your heart block and ask how they plan to manage it.

        Have you talked to Lisa? She can talk to you on a specific, individual basis. You know answers here are just general info and not medical advice for individuals. I'm sorry you are feeling so bad. I think if you pursue this whole thing, you can get answers that will help you. I hope so. Please keep us posted. Linda


        • #5
          Hi Darek,
          First let me say that my cardio has me on drugs to keep my systolic pressure in the 140’s – and my pulse rate in the 60’s. What you’ve reported on your AV block and the pulse rate in the sixties may well be two different issues, one desired, the other not so thrilling.

          Here is what I think is a clear picture of AV blocks. It might pay you to find out more information about your particular situation. - - -

          The heart has four chambers. The top two are called the atria. The bottom two are called the ventricles.

          The heart's "natural" pacemaker is called the sinoatrial (SA) node or sinus node. It's a small mass of specialized cells in the heart's right atrium. It produces electrical impulses that make your heart beat. For your heart to beat properly, the signal must travel from the SA node down a specific path to reach the ventricles. As the signal goes from the atria to the ventricles, it passes through specialized conducting tissue called the atrioventricular (A'tre-o-ven-TRIK'u-ler) (AV) node.

          On an electrocardiogram (e-lek"tro-KAR'de-o-gram) (ECG or EKG), a portion of the graph called the P wave shows the impulse passing through the atria. Another portion of the graph, the QRS wave, shows the impulse passing through the ventricles. As long as the impulse is transmitted normally, the heart pumps and beats at a regular pace.

          What is heart block?
          Sometimes the signal from the heart's upper to lower chambers is impaired or doesn't transmit. This is "heart block" or "AV block." This does not mean that the blood flow or blood vessels are blocked.
          Heart block is classified according to the level of impairment -- first-degree heart block, second-degree heart block or third-degree (complete) heart block.

          What is first-degree heart block?
          First-degree heart block, or first-degree AV block, is when the electrical impulse moves through the AV node more slowly than normal. The time it takes for the impulse to get from the atria to the ventricles (the PR interval) should be less than about 0.2 seconds. If it takes longer than this, it's called first-degree heart block. Heart rate and rhythm are normal, and there may be nothing wrong with the heart. Certain heart medicines such as digitalis (DIJ'ih-TAL'is) can slow conduction of the impulse from the atria to the ventricles and cause first-degree AV block. Also, well-trained athletes may have it. Generally, no treatment is necessary for first-degree heart block.

          What is second-degree heart block?
          In this condition, some signals from the atria don't reach the ventricles. This causes "dropped beats." On an electrocardiogram, the P wave isn't followed by the QRS wave, because the ventricles weren't activated. There are two types:
          • Type I second-degree heart block, or Molitz Type I, or Wenckebach's AV block. Electrical impulses are delayed more and more with each heartbeat until a beat is skipped. This condition is not too serious but sometimes causes dizziness and/or other symptoms.
          • Type II second-degree heart block, or Molitz Type II. This is less common than Type I but generally more serious. Because electrical impulses can't reach the ventricles, an abnormally slow heartbeat may result. In some cases a pacemaker is needed.

          What is third-degree or complete heart block?
          Complete heart block (complete AV block) means that the heart's electrical signal doesn't pass from the upper to the lower chambers. When this occurs, an independent pacemaker in the lower chambers takes over. The ventricles can contract and pump blood, but at a slower rate than that of the atrial pacemaker.

          These impulses are called functional or ventricular scope beats. They're usually are very slow and can't generate the signals needed to maintain full functioning of the heart muscle. On the electrocardiogram, there's no normal relationship between the P and the QRS waves.

          Complete heart block is most often caused in adults by heart disease or as a side effect of drug toxicity. Heart block also can be present at -- or even before -- birth. (This is called congenital heart block.) It also may result from an injury to the electrical conduction system during heart surgery. Complete heart block may be a medical emergency with potentially severe symptoms and a serious risk of cardiac arrest (sudden cardiac death). If a pacemaker can't be implanted immediately, a temporary pacemaker might be used to keep the heart pumping until surgery can be performed.


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