Third degree AV block history and symptoms

Patients with third degree AV block typically experience a lower overall measured heart rate, low blood pressure. Most of the patients will experience in physical activities , as the heart cannot react quickly enough to sudden changes in demand or sustain the higher heart rates required for sustained activity. Complete heart block associated with a slower pacemaker can result in dizziness, presyncope and syncope.

Patients with third degree AV block typically experience a lower overall measured heart rate, low blood pressure. In some cases, exercising may be difficult, as the heart cannot react quickly enough to sudden changes in demand or sustain the higher heart rates required for sustained activity. Complete heart block associated with a slower pacemaker can result in dizziness, presyncope and syncope.

Patients with third-degree AV block may have a positive history of:

• History of cardiac disease
• History of use of medications that affect the conduction through the conducting system (beta blockers, calcium channel blockers, digitalis)
• History of previous cardiac interventions (aortic valve surgery TAVI, ASD, VSD and TGA repairs, ablation procedures etc.,)

Patients with complete heart block present with varied symptomatology.^[1][2]

• Some patients may be asymptomatic or have symptoms related to hypotension such as::
  • Dizziness
  • Fatigue
  • Presyncope
  • Syncope
• Complete heart block with narrow QRS comples (level of block above His bundle) is associated with minimal symptoms.
• Patients with complete heart block and wide QRS complex (level of block below the His bundle) may present with:
  • Dyspnea
  • Syncope
  • Chest pain
  • Sudden cardiac death

Less common symptoms of third degree AV block include:

• Confusion
• Paradoxical feeling of heart racing (sensing the heartbeat due to irregular rhythm and/or sudden change in heart rate)
• Cold extremities
• Cyanosis

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