 HeartBlock is a type of bradycardia (too-slow

heartbeat) that also is called atrioventricular ,

or AV block. In this condition, the electrical
signals that stimulate heart muscle
contractions are partially or totally blocked
between the upper chambers (atria) and the
lower chambers (ventricles).
 Heart block refers to a delay in the
normal flow of electrical impulses
that cause the heart to beat.
CONGENITAL HEART BLOCK
ACQUIRED HEART BLOCK

After a person suffers from a heart attack,

scar tissue can develop as a result. The scarring can
then lead to an acquired heart block.
 Coronary artery disease
 Cardiomyopathy (disease of the heart muscle),
coronary thrombosis (sudden blockage in your heart's
blood vessels).
 Myocarditis (inflammation of the muscle in the wall
of the heart).
 Valvular heart disease (disease of the heart valves)
 Certain medicines (including beta-blockers, digoxin,

verapamil and amiodarone).

 Certain infectious diseases (such as Lyme disease).
 Other diseases such as rheumatoid arthritis and

systemic lupus erythematosus.

Congenital Heart Block
 If a pregnant woman has an autoimmune
disease, such as lupus, her fetus is at risk for
heart block.
 Autoimmune diseases can cause the body to
make proteins called antibodies that can
cross the placenta. (The placenta is the organ
that attaches the umbilical cord to the
mother's womb.) These antibodies may
damage the baby's heart and lead to
congenital heart block.
 Congenital heart defects (problems with the
heart's structure) also may result in
congenital heart block.
 Heredity may play a role in certain heart

defects.
First Degree Heart Block (1 º)
 SA Node – normal
 Normal P wave
 AV Node conducts more slowly than
 normal
 Prolonged PR Interval
 Rest of conduction is normal
 Normal QRS
 PR Interval > 0.2 seconds (5 small sq)

 Note ––the PR Interval is constant

Clinical significance
 None

Treatment
 None

Note –this can progress to this 2ºor 3ºheart

block
 Mobitz Type I ( Wenkebach Wenkebach)

 In this type , the electrical signals are delayed more and

more with each heartbeat, until the heart skips a beat.
On the ECG, the flat line between the P and the QRS
waves gets longer and longer until there's no QRS
wave.
Clinical Significance
 Slight symptoms eg. Lethargy, Confusion

Treatment
 Pacemaker if during day &/or symptoms
 No treatment if at night

Note – this can progress to 3 º Heart Block

 In this type, some of the electrical signals
also don't reach the ventricles. However, the
pattern is less regular than it is in Mobitz
type I.
 Some signals move between the atria and
ventricles normally, while others are blocked.
On an ECG, the QRS wave follows the P wave
at a normal speed. Sometimes, though, the
QRS wave is missing (when a signal is
blocked).
Clinical significance –
this is more significant disease

Treatment – pacemaker

 Note – this can progress to 3 º Heart Block

 In this type of heart block, none of the electrical
signals reach the ventricles. This type also is
called complete heart block or complete AV
block.
 When complete heart block occurs, special areas
in the ventricles may create electrical signals to
cause the ventricles to contract. This natural
backup system is slow and isn't coordinated with
the contraction of the atria. On an ECG, the
normal pattern is disrupted. The P waves occur at
a faster rate than the QRS waves.
clinical significance
 Symptoms LOC, Confusion, Dizziness, low
BP.

Treatment
 pacemaker
 Syncope (fainting) .
 Dizziness .
 Lightheadedness .
 Chest pain .
 Shortness of breath exercise/activity.
 seizures, caused by not enough oxygen

getting to the brain.

 To help reduce your chances of getting heart block,
take the following steps:
 Obtain treatment for any underlying heart problems
or heart disease. This will help prevent heart block.
 If possible, avoid medications that can cause heart
block, such as beta blockers, calcium channel
blockers, and digitalis.
 Maintain a healthy weight and lifestyle. Get regular
exercise, eat a heart-healthy diet, and minimize
stress.
 Avoid excessive consumption of alcohol and caffeine.
 Stop smoking.
