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Treatment generally depends on the degree of heart block that is present:
- First-degree heart block generally requires no treatment, although some people may need to be treated for an underlying electrolyte imbalance. If medications are causing the condition, a physician may reevaluate the dosage or advise the patient to stop taking it. Medications should not be adjusted without consulting a medical professional. A physician may recommend follow-up with a cardiologist to be sure that the patient does not develop a more severe form of heart block. Follow-up is particularly important if first-degree heart block developed as a result of a past heart attack or myocarditis. In patients with severe heart failure and first-degree heart block, implantation of a pacemaker may sometimes improve cardiac performance. Otherwise, further treatment is generally unnecessary and prognosis is excellent.
- Type I second-degree heart block is generally treated by addressing any underlying conditions that are contributing to it. Temporary pacing and/or medication (e.g., atropine) may be required if the heartbeat is too slow, but a permanent pacemaker is generally not necessary unless the condition worsens.
- Type II second-degree heart block often produces noticeable symptoms and carries a significant risk of potentially life-threatening complications. Therefore, treatment is very important. A physician may administer medications (e.g., atropine) and recommend the implantation of an artificial pacemaker. If the condition worsens to third-degree heart block, then a temporary pacemaker wire may be needed during the medical crisis until a permanent pacemaker can be inserted.
- Third-degree heart block patients almost always require an artificial pacemaker to better regulate the electrical activity of the heart. If a medical crisis occurs before the pacemaker can be implanted, then a temporary pacemaker wire may be used to keep the heart beating. Most patients who are diagnosed with complete heart block will require placement of a permanent pacemaker, unless a treatable cause is identified and corrected.
Researchers are exploring various gene therapies as a way of transforming certain tissue cells into those that can pace the heart.
The best strategy for preventing heart block is to prevent the heart conditions that contribute to heart block.
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