In a post last week I referred to the fact that I had noticed creases in my ear lobes, which immediately raised concern, since this can be a sign of heart disease. Today I went to the doctor and had a EKG. Because of my age, I suppose, at first he did not seem at all concerned when I asked him for an EKG, mentioned the ear lobe creases, and described my symptoms and history. He is a bit of a joker, but after he read the results of the EKG he wasn’t joking anymore.

He said he’d have to send the EKG to a cardiologist for review to know for sure, but it appeared I have AV Block.

Atrioventricular conduction disease (AV block) describes impairment of the electrical continuity between the atria and ventricles. It occurs when the atrial depolarization fail to reach the ventricles or is conducted with a delay. It can result from an injury or be a genetically inherited disorder.[14]

Heart block refers to an abnormality in the way electricity passes through the normal electrical pathways of the heart. The abnormality “blocks” the electrical impulse from continuing through the normal pathways and usually results in a slower heart rate.

What causes heart block?

Heart block can be caused by:

Heart block is more common in older people and may be the result of age and a combination of factors listed above. Heart block can occur in people who have had a heart attack. When heart attacks cause heart block, it often goes away on its own. But if the heart attack is extensive, the heart block may be permanent and require a pacemaker.

Where does the block occur?

The electrical activity of the heart starts in the sinoatrial (SA) node in the upper chamber (atrium) and travels through the atrioventricular (AV) node to reach the lower chamber (ventricle). Heart block may occur at any point along this electrical pathway. Heart block of the AV node can be of several types, and a doctor generally can diagnose these by looking at the person’s electrocardiogram (EKG, ECG).

What is atrioventricular (AV) block?

First-degree AV block

In first-degree block, the electrical impulses take longer to travel between the upper chamber (atrium) and lower chamber (ventricle) of the heart. This type of heart rhythm may or may not be associated with a slow heart rate.

It does not usually require treatment. But this type of heart block may raise your risk of heart rhythm problems, such as atrial fibrillation.

Second-degree AV block

In second-degree heart block, some of the electrical impulses are blocked between the upper and lower chamber of the heart. These electrical impulses may or may not have a clear pattern. The blocking of the impulse can come and go, resulting in “dropped heartbeats.” A second-degree type II block may progress to complete or third-degree heart block.

Second-degree heart block can be categorized into two types:

  • Mobitz type I block (also called Wenckebach) usually occurs in the AV node. It is common in young, healthy people (especially during sleep). It usually does not cause symptoms and rarely requires treatment.
  • Mobitz type II block usually occurs below the AV node in other conduction tissue. It may be part of aging. It is also seen in people with significant heart disease or during a large heart attack. It may cause lightheadedness or fainting (syncope). And it may progress to complete heart block. This type frequently requires a pacemaker.

Complete or third-degree block

Third-degree heart block is a serious condition that affects the heart’s ability to pump blood effectively. Symptoms include fainting, dizziness and sudden heart failure. If the ventricles beat more than 40 times per minute, symptoms are not as severe, but include tiredness, low blood pressure on standing, and shortness of breath.

In third-degree heart block, all of the electrical impulses are completely blocked between the upper and lower chambers of the heart. When this occurs, the atria and ventricles beat at completely different rates.

Complete heart block is caused by the aging process, medicines, heart attacks, infiltrative heart diseases (amyloidosis, sarcoidosis), and infectious diseases (endocarditis, Chagas disease). It may also occur after heart surgery and can be present from birth (congenital).

Complete heart block frequently causes symptoms of lightheadedness or fainting and usually requires the placement of a permanent pacemaker. People who are born with complete heart block (an uncommon congenital condition) often have no symptoms and may not need treatment initially. But eventually they almost always require pacemaker placement.

Treatment

Some second- and almost all third-degree heart blocks require an artificial pacemaker. In an emergency, a temporary pacemaker can be used until an implanted device is advisable. Most people need the pacemaker for the rest of their lives.

Prognosis

Most people with first- and second-degree heart block don’t even know they have it. For people with third-degree block, once the heart has been restored to its normal, dependable rhythm, most people live full and comfortable lives.

What is bundle branch block?

Bundle branch block can affect the heart’s rhythm. The heart has structures, like wires, that are called bundle branches. They are part of the heart’s electrical pathway. When a branch is diseased, it is called “blocked,” because the electrical signals can’t travel down the branch.

Some people with bundle branch block don’t have any symptoms and don’t need treatment. But when a block causes the heart to beat too slowly, it can cause symptoms such as tiredness and fainting spells. A pacemaker may be used to get the heartbeat back to normal.
Research Sources:

WebMed

Medical Dictionary

Third-degree heart block is a serious condition that affects the heart’s ability to pump blood effectively. Symptoms include fainting, dizziness and sudden heart failure. If the ventricles beat more than 40 times per minute, symptoms are not as severe, but include tiredness, low blood pressure on standing, and shortness of breath.

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