Heart Block

WHAT YOU SHOULD KNOW:

• Heart block is also called an atrioventricular (a-tre-o-ven-TRIK-u-ler) or AV block. Heart block occurs when there is a problem in the way the electrical signals of the heart flow. The flow of electrical signal controls the way the heart pumps out blood. Normally, the signals come from the atrium (upper chamber of the heart) then pass through to the ventricle (lower chamber of the heart). The electrical signals spread to the ventricles causing the muscles to pump blood. With heart block, there is a delay or interruption in the flow of electrical signals.
  
  
• The most common cause is scar tissue formed on the path of the electrical signals. Heart block may result from previous heart conditions including myocardial ischemia (decreased blood supply to the heart), infections, tumors, or surgery. Certain heart medicines may also cause heart block. Heart block may also be a condition you are born with.
  
  
• Signs and symptoms depend on the severity of heart block. Sometimes you may have no symptoms at all. Symptoms of dizziness, fainting, confusion, or tiredness may occur if the heart block is partial or complete. Diagnosis may include ambulatory monitoring, stress test, echocardiogram, or EKG. Treatment includes certain heart medicines, and pacemakers or implanted cardioverter devices in severe cases.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Early diagnosis and immediate treatment is often needed. Severe heart block if left untreated may make your symptoms worse and could lead to death. Ask your caregiver if you have questions about your heart block, medicines, and treatments.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

At first you may need to lie down in bed and rest. Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away. Then call your caregiver.

Heart monitor:

This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

Medicine:

• Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.
  
  

Tests:

• Ambulatory monitoring: This is also known as a Holter monitor, ambulatory electrocardiogram, or loop monitor. These devices record your heartbeat from several hours to days or weeks. Sticky pads are placed on your chest. The pads are connected with wires to a small device. The machine can be attached to your belt so it does not interfere with your everyday activities. Your caregivers look at the reading to see problems with your heartbeat.
  
  
• Echocardiogram: This test is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart.
  
  
• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Exercise stress test: This test helps caregivers see the changes that take place in your heart during exercise. It checks for blockages in the arteries of your heart. An EKG is done while you ride an exercise bike or walk on a treadmill. Caregivers will ask you how you are feeling during the test. They want to know if you have chest pain or trouble breathing.

Treatment options:

• Implanted cardioverter defibrillator:
  
  
  • An implanted cardioverter defibrillator is also called an ICD. It is a small device that monitors your heart rate and rhythm. If your ICD senses that your heart is beating in an unhealthy rhythm, it will give your heart a small electrical shock. This helps your heart start beating normally again.
    
    
  • An ICD is made up of a generator and leads (thin, flexible wires that attach to your heart). The generator and the leads will be placed inside you during a procedure. The generator has a metal shell with a battery and a small computer inside.
  
  
• Temporary pacemaker:
  
  
  • This is a machine that helps your heart beat at a normal speed and in a regular rhythm. A temporary pacemaker may use large patches placed on your chest and back. These are connected to a special monitor. Sometimes, your caregiver may need to put small wires through your skin and into your heart muscle instead. The wires may then be connected to a small pacemaker box outside of your body.
    
    
  • The temporary pacemaker "reads" what your heart is doing. If your heart is beating in a different way than it should, the pacemaker takes over and controls your heartbeat. It does this by sending small electric signals to the heart muscle. This tells your heart when to beat. You may feel these signals, especially if your temporary pacemaker uses large patches on the skin. If this causes pain, use your call light and tell your caregiver. Do not get out of bed without first asking your caregiver if it is OK. You may need a pacemaker just for a short time. In some cases, you may need it for the rest of your life. If so, your caregiver may replace your temporary pacemaker with a permanent one.
  
  
• Permanent pacemaker:
  
  
  • A permanent pacemaker is a small device that helps control your heart rate. A permanent pacemaker is about the size of a wristwatch, and is implanted under your skin. You may need a pacemaker to slow your heartbeat down, speed it up, or make it more regular.
    
    
  • A pacemaker is made up of leads and a generator (battery). Getting a pacemaker involves having a procedure done. Most pacemakers work only when they are needed. These are called demand pacemakers. Other pacemakers work all the time. Your caregiver will decide which pacemaker is right for you.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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