My first EP, 1.5 years ago, diagnosed me with a complete A/V block and recommended a pacemaker. I have researched complete A/V block and it is my understanding that means no electrical signals pass from the atria to the ventricles. If I had a full-time 3rd degree heart block, prior to the pacemaker, how did I survive? I began seeing a new EP several months ago- he diagnosed me with 2nd degree heart, Mobitz type 2. Does that mean I don't have complete heart or A/V block? My pacemaker pacing percentages have varied, but have a range of about 5% to 15% since the pacemaker was implanted. It seems that an individual with 3rd degree or complete heart block would have a pacing percentage of 100%. Is 3rd degree or complete heart block sometimes intermittent and not a permanent, full-time condition?
You can survive 3rd degree AV with escape beats. Sometimes it's called juncitonal rhythm, or junctional escape. Escape beats are the Ventricle's backup mechanism. I've heard of it coming and going but you really want to identify the root cause of the AV block to really know what the future holds.
I never expected anything to reverse itself or "improve". I just didn't understand how my first EP could diagnose Complete A/V block when I have never had a left ventricular block nor any structural problems diagnosed with the left ventricle's conduction system. The only structural defect diagnosed by anyone is "downstream of the A/V node and only in the right ventricle". I think that the first EP must have diagnosed, in error, a 3rd degree, complete heart block. The second EP diagnosed 2nd degree block, Mobitz type 2. Thanks for your replies.
The conflicting diagnosis is frustrating. I've not ever heard of 3rd degree being intermittent. The diagnosis of 3rd degree is a serious. The muscle in that area has to be heavily damaged and that's usually ischemia, auto immune, or a congenital issue.
Given your pacing ratio it sounds like 2nd degree is the right one.
If it were me, I would definitely bring this up with the 2nd EP to see what they say. It's fair to clear up the confusion for you. You are going to be the strongest advocate for your care, so you have to have the knowledge.
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