2nd Degree Heart Block Treatment

Introduction

Second-degree heart block is a condition where the electrical signals that control your heartbeat are partially blocked or delayed. It is classified into two types: Mobitz Type I (Wenckebach) and Mobitz Type II.

Types and Treatment

Mobitz Type I (Wenckebach)

  • This type usually does not require treatment unless it causes significant symptoms such as dizziness, fainting, or severe bradycardia (slow heart rate).
  • If symptomatic, treatment may include:
    • Correcting underlying issues (e.g., stopping certain medications like beta-blockers, calcium channel blockers)
    • Pacemaker placement in severe cases with persistent symptoms
  • In emergency settings, atropine or temporary pacing may be used.

Mobitz Type II

  • This is more serious as it can suddenly progress to complete heart block.
  • Treatment options:
    • Permanent pacemaker implantation is usually required, as this type does not improve with medications.
    • Temporary pacing may be needed in emergency cases before a permanent pacemaker is implanted.
    • Addressing underlying conditions, such as electrolyte imbalances or ischemic heart disease.

When to Seek Medical Help?

  • If you experience fainting (syncope), dizziness, chest pain, or significant fatigue.
  • If you have a history of heart disease and develop a slow or irregular heartbeat.

Conclusion

Second-degree heart block needs to be evaluated carefully. While Mobitz I can sometimes be managed conservatively, Mobitz II almost always requires a pacemaker to prevent progression to life-threatening heart block.

Source recommendations

1. American Heart Association (AHA) Guidelines on Bradycardia and Conduction Delay

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000628
  2. https://pubmed.ncbi.nlm.nih.gov/30412710/
  3. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/conduction-disorders
  4. https://pubmed.ncbi.nlm.nih.gov/30586772/
  5. https://www.jacc.org/guidelines/bradycardia

2. European Society of Cardiology (ESC) Guidelines on Cardiac Pacing and Resynchronization Therapy

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiac-Pacing-and-Cardiac-Resynchronization-Therapy
  2. https://academic.oup.com/eurheartj/article/42/35/3427/6358547
  3. https://pubmed.ncbi.nlm.nih.gov/34455430/
  4. https://academic.oup.com/eurheartj/article/34/29/2281/401445
  5. https://pubmed.ncbi.nlm.nih.gov/23801827/

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