Complete Heart Block healed

[jtcaputo]

Two years ago I was diagnosed with a complete heart block and received a pace set to pace at 60. At my latest pacemaker check-up, the tech told me I am now pacing myself. She reset the pacemaker to fire only when needed - below 60. My question is how is it possible for a complete heart block to "heal" itself? Should I request a consult with my cardiologist?

[itdood]

The 30bpm rate seems to fit with Third-degree AV block (complete).  Since the ventricles wouldn't be getting a signal to beat the ventricles would fall back to a fail safe that's called "escape rhythm"  There are some pacers located in the ventricles that are there just-in-caser.  Their action potential is lower and thus a lower rate.  also wouldn't be in synch with atrial rhythm.    The reason for this is because you can't survive without the ventricles working.  You can be in complete atrial fibrillation for years and survive just fine.  Not so much with the ventricles.  If they stop it's lights-out.  So, even if your PM stopped working you'd still have the fail safe.

I've read that 3rd degree can resolve naturally. It can be intermittent, permanent, 1 time issue....Doesn't hurt to discuss with your cardiologist!

[jtcaputo]

Thank you, Piparskeggr and itdood for your comments. The word that is most mystifying for me is "complete." It seems to imply finality. The doctor who made the initial diagnosis is a heart electrical specialist. I specifically asked him at the time, if the condition was reversible because I seemed to remember reading about the heart's ability to create a "work-around." I wanted to wait a few weeks to see if that would happen. (If you think that is funny, consider that at the time, I was on a gurney in the ER with a heart rate under 30.) He told me that I would need the pacemaker the rest of my life.

[Piparskeggr]

Angiogenesis, interesting...could be why my grandfather survived 4 heavy duty attacks between 75 and 90...he passed just before Thanksgiving at 99 1/2.

[itdood]

Very neat.  I've heard of certain viral or bacterial illnesses that can cause block and eventually resolve.  Lymes disease is the main one that comes to my mind.

I would think you should be seeing your cardiologist every 6 months or so?  yes, pay them a visit and see what's up.  You've had a change in status and they should be made aware and should evaluate next steps.

Piparskeggr, I think what your Mom had happen is called angiogenesis.   It's cool stuff.  Older folks tend to have more of this and it actually helps them survive heart attacks better than younger people.  When someone in their 40s has an MI it's usally bad because they don't have those alternate routes that older folks would have developed.

[Piparskeggr]

Good evening;

I have had a twin lead pacemaker for over 3 years.  Without it I go into Sinus Arrest; normal heartbeats, then flat line, then normal again.

At the 6 week baseline check after the implantation, I was pacing 15% of the time for the atrium and 4 % of the time for the ventricle, with the threshold at 50 beats per minute.

At my most recent check in June; just under 6% Atrial and just over .2% Ventricular pacing.

An almost 13% reduction over 3 years.

The analysis I received is that the pacer gave my heart muscles and nerves a chance to heal and relearn their own job.

I am very fortunate in that my heart problem is a strictly electrical one.  I suffered no damage in the estimated "...could have been over 100..." episodes before the diagnosis and pacer.

Definitely, talk with your cardiologist.  Our bodies are amazing.

My mom showed as having 4 blockages, which led to open heart, by-pass surgery.  When they got in, her heart had grown a shunt around what the cardiologist thought was the oldest of the 4 by the solidity of the plaque mass, resulting in 3 by-passes, instead of 4.