Hello..Newbie Here-Complete Heart Block

I am so glad I found this site. I am almost 58 with no serious heart problems in the past. I was diagnosed a few years ago with a leaky valve (not mitral valve prolapse but something like it) and an irregular heart beat and sometimes rapid. I have been taking 100 mgs. of Toprol XL for a few years now. Two Sundays ago I was at work when I started feeling weird. Heart racing, feeling hot, weakness in legs, hard time breathing. Went to ER and they told me I had complete heart block and very low pulse rate. Docs thought maybe it was the Toprol causing the problem. So, I was admitted and they stopped the Toprol...no change after 3 days. That's when my cardio said I need a pacemaker. He had another cardiologist do the operation. I have now had it for almost 2 weeks. St. Jude, dual lead. Can't get my mind around this. Then, a few days ago I went to the cardio that installed it and he told me my heart block was gone! That my pacemaker had only been used 1% of the time since they put it in. I was shocked as they told me previously the heart block would never go away. Not complaining...this is wonderful but makes me wonder if these docs know what they are doing. He also told me it could come back at any time. They have no idea why this happened. I do not have heart disease, no heart damage. But I do have the leaky valve and irregular heart beat at times. I see my regular cardiologist in two days for first follow up. He doesn't do pacemakers and I guess will have a tech from St. Jude come in with their fancy machine to check me out. This is all so scary to me.

Anyone have complete heart block and then have a doc tell you it's gone a week after pacemaker was implanted?

Take care,
Vicki

7 Comments

Hi Vicki,

by hooimom - 2007-07-31 04:07:39

I have never heard of that before! Quite amazing. What are they going to do now? If the heart block happened once are they concerned it could occur again?

Michelle

Heart Block

by Vicki - 2007-07-31 06:07:20

Hi Michelle, thanks for noting me. Doc said it could come back at any time. Don't understand but hopefully my cardiologist can explain better. I see him on Thursday.

Amazing

by hooimom - 2007-07-31 07:07:20

Vicki,

I am still amazed. I thought, once a heart block always a heart block! I have read your posts to other newbies.I found it very healing to share with others right after my PM. I guess I still do! You are wonderful to share support with others as you are still figuring out your own situation.

Michelle

Wow!

by auntiesamm - 2007-08-01 02:08:29

Hi Vicki - Your story is a repeat of mine..... almost. I developed symptoms quite like you at work. Thought I was getting the flu because of fatigue, profuse sweats, etc. Checked my BP on home monitor - it would not register and pulse was 30 so I knew something was wrong. Got to my doc's office, she did an EKG and I was in 3rd degree HB. Sent me directly to the ER - my husband drove, of course. Cardio thought because of the high doses of beta blocker that could be the cause so they ran lots of IV fluid to try to clear it out of my system. After 24 hours there was no change and in fact my HR dropped to 26 in ICU. Nurses were on the standby with defib paddles. Anyway, long story short - within 48 hours I had my PM and what a great difference it made! I realized after the fact that I had been having minimal symptoms all along that I had discounted as an inconvenience. Did not connect them to anything pathological. At my first PM check at 2 weeks post my PM was firing infrequently which the doc explained to me - it could be that for periods of time my heart does well on its' own and doesn't need the PM assist but when it DOES the PM fires. This made sense to me so I did not question any further. And, I was feeling better than I had in a long time. The extreme fatigue from putting one foot in front of the other was gone and my skin "pinked" up again. I had not realized how pale I was until my daughter pointed it out. When I had my one year PM check in April I was 100% dependent in the left ventricle and 52% in the atria. I feel so fortunate that I did not have a blackout whiile driving or doing something else that could have put me and others in danger. The thought now sends chills up my spine. Back to what your doctor said about your not needing the PM. Is it possible that only on occasion you experience heart block and at the time he was checking you out your heart was sending it's own electrical signal? Don't know much about all this stuff but Smitty does. I am going to ask him to tell you what he told me after I got my PM. He is like our resident expert on things scientific, electrical, etc.. In my first few weeks post-PM he was my life-saver. God bless you and I hope we hear more from you.
Sharon

Complete Heartblock.

by Stepford_Wife - 2007-08-01 09:08:43

Hi Vicki.

I have complete heart block, from AV nodal ablation; So mine will never go away, unless the AV node grows back, which is highly unlikely, but who knows?
At any rate, I have found this article that might interest you, and answer a few of your questions.

~ Dominique ~

Heart block is a disorder of impulse conduction, meaning that an electrical impulse is impaired from traveling along its normal pathway. Heart block is also called atrioventricular block, because it often occurs in the atrioventricular, or A-V, node, which transmits electrical signals from the atria (the upper chambers of the heart) to the ventricles (the lower chambers of the heart). Depending on its severity, A-V block may be an abnormal delay, a partial interruption, or a complete interruption of the impulse. Delays often have no symptoms, but can cause the heart rate to fall so far below normal that it causes dizziness or fainting. Certain forms of intermittent block may occur in normal people during sleep and cause heart rates of 40 beats per minute and even lower.

Physicians classify heart block based on the length the delay:
In first-degree heart block, the ECG shows one QRS wave for every P wave, but the pause is greater than normal.
In first-degree heart block, the ECG shows one QRS wave for every P wave, but the pause is greater than normal.
First-degree heart block: Heart beat impulses are delayed in the A-V node, but ultimately reach the ventricles. Sometimes, first-degree heart block can eventually lead to other forms of heart block.

Second-degree heart block: Heart beat impulses are delayed or blocked in or around the A-V node, and some of the impulses fail to reach the ventricles; Second-degree heart block is further divided into two sub-types:

* Type I second-degree heart block, also called Mobitz Type I heart block or the Wenckebach phenomenon.
* Type II second-degree heart block, also called Mobitz Type II block.



In second-degree type II block, notice that the P wave (4th bump) isn't followed by the QRS wave, because the ventricles weren't activated.
In second-degree type II block, notice that the P wave (4th bump) isn't followed by the QRS wave, because the ventricles weren't activated.
Third-degree heart block: Also called complete heart block, each sinus node impulse is completely interrupted in the A-V node or beyond, and the ventricles must generate their own impulse to contract. Depending on its cause, third-degree block may be transient (temporary) or permanent.

WHAT ARE THE SYMPTOMS?

Heart block symptoms can vary according to its type, frequency, duration, and whether underlying structural heart disease is present. Heart block can contribute to bradyarrhythmia, or an arrhythmia that causes an abnormally slow heart rate (fewer than 60 beats per minute). People with bradyarrhythmia may experience the following symptoms:

* Dizziness or lightheadedness;
* Low blood pressure;
* Palpitations (the sensation of skipped beats);
* Fatigue; and
* Syncope (fainting).

CAUSES AND RISK FACTORS

Heart block may occur at any age, but commonly becomes more frequent during middle age and is associated with aging. Among people without heart disease, the exact cause of heart block may be unknown. Milder forms of heart block may be caused by certain medications, including:

* Adenosine;
* Calcium channel blockers;
* Beta-blockers; and
* Digitalis.

Certain diseases can cause heart block, including:

* Endocarditis (inflammation of the tissue that lines the heart);
* Myocarditis (inflammation of heart muscle tissue);
* Lyme disease;
* Lenègre disease;
* Lev disease;
* Coronary heart disease; and
* Heart attack.

Some kinds of heart block can be caused by what physicians call increased vagal tone, which occurs when the vagus nerve, which controls involuntary bodily functions including heart rate, is stimulated, causing an abnormally slow heart rate. Heart block, especially in children, may also be congenital, meaning present when a person is born. People who have undergone corrective heart surgery may also develop heart block.

DIAGNOSIS

Because heart block may be unpredictable and brief, the condition can be difficult to diagnose. In addition to taking a person's medical history, listening to the patient describe symptoms, and conducting a physical examination, the physician will use one of the following tests: resting electrocardiogram, or ECG, or an ambulatory ECG using a portable machine called a Holter monitor.

TREATMENT APPROACH

A person's heart block may resolve naturally. In some cases, heart block may not be frequent, sustained, or bothersome enough to require treatment. Other forms of heart block can be controlled once the underlying heart disease. For example, in people who take a heart medication that may cause heart block, physicians may discontinue the use of the drug. When a person develops complete heart block following a heart attack, for example, the heart block may resolve with the healing of the area of heart muscle affected by the heart attack.

More severe forms of heart block that cause symptoms may require treatment, including pacing, which is the use of a pacemaker for electrical stimulation of the heart, and medication.

Common medications for heart block include atropine and isoproterenol. These drugs may be used in the short-term to treat a slow heart rate that causes symptoms, but second- and third-degree heart block may be unresponsive to atropine.

Heart Block

by Jocko7745 - 2007-08-07 12:08:06

Vicki,

I had an ER experience with heart block last week that wound up with me getting a PM as well. I had had some episodes of heart block 5-6 years ago but it went undiagnosed. Then last Wed. I was in complete heart block, passed out and wound up in surgery. While in the hospital before the procedure I had numerous episodes of heart block and nearly died. After the procedure, I did not have one instance where the PM kicked in. I have no answers, but I seems plausible to me that I will not need the PM for many years. However, it is a comfort to know that it is there monitoring the situation so my family and I do not need to worry about reocurrences. I wish you the very best!

Jack

Vicki

by wchuddles - 2007-09-15 12:09:14

I am 60 years old. Two years ago, I had a bloodclot in my ventrical that caused me to have a heart attack. It was most likely caused by a condition I had of irregular heart rhtymns. I was taking quinadine and lanoxin for it, and had been for 35 years. I was always aware that I had irregular heart beat. I could feel it. It would beat fast and then slow to a pounding. I would feel weak and dizzy. The medication kept most of it in check.

I had a three lead St. Jude defibrillator installed shortly after the heart attack. After the heart attack, I developed an irregular heart beat. The doctors told me that they could possibly stop it by entering my heart with a small probe, and "scorching" the areas causing the irregular beat. It seems that in addition to the nodes that cause the heart to beat, I had places in regular heart muscle that were reacting on their own. The scorching was to stop those muscles from contracting. During the procedure, the doctor was unable to do the scorching. He could not find the areas causing the problem He had to have a regular heart beat in order to fix it. He could not shock my heart into a normal rhythm.

So, he said I must have a defibrillator. He installed it two years ago in October. Since installation, I have had no irregular heart beat that I am aware of. I used to have it before my problems, and was aware of the irregular beat. My defibrillator is there in case I do have it. It would shock my heart back into a normal rhythm.

I think the doctor telling you that the defibrillator is not working but 1% of the time is telling you that you do need it, but that it is just not having to work all the time. Your heart is functioning on its own most of the time. It only needs help occassionally. With my defibrillator, I can exercise and my heart rate will increase to a 100 beats per minute rhythm. It is set to beat at 70 beats per minute.

The first time I went to have my defibrillator checked, the tech told me that I had had 147 episodes of use by the defibrillator. I later talked to another tech and he told me that I had had no use.

I know that I have never been shocked by it. However, while at the heart doctor, I met a man who had been shocked numerous times by other models of defibrillators. He was on his third model. The first he had was a one wire lead. The second had two leads. The third had three leads. The third was a St. Jude model. He had never been shocked by the St. Jude.

I am no expert, but I believe that without the defibrillator that I have, I would be dead. My heart was skipping beats, etc. The doctor said that ventricular arhythmia is more likely to cause blood clots in the heart than atrial arhythmia. Fortunately, I have had no ventricular arhythmia due, I think, to the pacemaker portion of my defibrillator that keeps my heart in good rhythm.

I wish you the best. I hope your defibrillator goes from 1% use to nothing. You have it for your protection if you ever do need it.

God bless.


Bill Huddleston
Senoia, GA 30276

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