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Forum Name: Arrhythmias

Question: Does a Second Degree AV Block dissappear?


 aeydownlow - Mon Mar 23, 2009 6:06 pm

Hi last 2007 I had an ECG and it stated there that I had a second degree AV block. According to my cardio it's okay I didn't need meds and I could go back to my normal life. I had the ECG and 3d Echo during my undiagnosed anxiety days. Last week I thought I was having a heart attack so I was rushed in the ER. The attending doctor took my ECG and told that it was normal there was no AV block of some sort. It was probably my anxiety.

So my question can a 2nd degree AV Block disappear?
 John Kenyon, CNA - Tue Mar 24, 2009 10:19 pm

User avatar Hi there --

Second degree AV block can go away. It can also be misread and go away. Assuming it was read correctly and was Mobitz Type I and not type II, it can go away. Since it did go away, it was either misinterpreted (unlikely but possible) or, well, it's gone. Type I (Wenckebach) is benign anyway, indicates nothing of any significance and requires no treatment. Type II (Hay) wouldn't likely go away on its own. Based on these things I'd say you're in good shape. It's one of those things that can show up one time and then never be caught again.

I hope you can get some help with the anxiety problem, which is a very real problem. If you can learn to differentiate between the sudden-onset symptoms that make you feel you're having a heart attack and the real symptoms it would be a great help, because with anxiety/panic attacks the symptoms generally start so quickly we don't have time to think it all through and assume the worst, which starts us into that dread spiral. This is fixable with insight and sometimes medication. It also can stir up benign cardiac symptoms and findings that only make us more anxious. Then something utterly unrelated to anything happens (like that finding of AV block) and, well, it really sets us up for more dread. So I hope you're looking for help with the anxiety issues.

I hope this has been helpful. Please follow up here with us as needed. Good luck to you.
 aeydownlow - Thu Mar 26, 2009 9:31 pm

Thanks I just read my old ECG and it says there I had 2 incidences of type II AV Block, followed by junctional escape beats. Should I be worried?
 aeydownlow - Thu Mar 26, 2009 9:38 pm

Sorry What they had on me was a holster for a whole day and those were the findings? Should I see my cardio again. He did advise to take another holster test after a year but only if I wanted to.
 John Kenyon, CNA - Fri Mar 27, 2009 11:03 am

User avatar A 24-hour Holter monitor recording generally will give a pretty typical picture of what someone's heart does on a routine basis. If there are unusual things (like sudden rapid beating) that only happen once in a while, a 30-say event monitor is better. In your case apparently you occasionally have brief periods of type II AV Block, which is unusual in its coming and going like that. With Type II there will normally be junctional (or even ventricular) escape beats, which means a blocking of the signal has occurred for long enough that the AV node decides to just fire off something to maintain the a constant rhythm.

While your cardiologist doesn't seem concerned, and since this only seems to be very occasional, I wouldn't be overly concerned. However, I, personally, would want to know what might be the cause of type II AV block and if it is likely to progress to the point where it may cause symptoms. Obviously your cardiologist doesn' think so, but since there's a big difference between type I and type II and the latter can become troublesome with time, I don't think you should be left to wait until you develop symptoms (lightheadedness, a fainting spell, etc.), mainly because if this happens it could be when you're doing something where you can't just sit yourself down til it passes. I'm confident your cardiologist knows what he's doing, but at this point you don't know what he's doing (and I'm not quite sure either), so I think it would be not only all right, but probably wise, to press him for some details about this, without undue concern, at least right now.

Good luck to you, and please do follow up with us and keep us updated.
 aeydownlow - Fri Mar 27, 2009 10:32 pm

Thank you so much. I will and I will post soon.

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