27 Y.O. with 2nd Degree AV Block Type 1

Hi, all. 

In early 2020 I was diagnosed with a 2nd degree AV block Type 1 after wearing a 48 hour holtor monitor that recorded two drops close to each other one of the two nights it was recorded. 

However, I think during the time it was recording my husband and I were having an argument (around 11 p.m. when the beats were dropped). I was wondering if the stress caused by an argument could have caused this to happen and it was a one time situation and not enough to truly be diagnosed. I have a follow up in February 2021 and will have a 2 week holtor monitor to see how often I am having beats dropped. I get mild symptoms, I believe, from time to time such as a mild tingle in my head for a second or two and then it goes away. In the afternoons while relaxing and watching television, I feel like my heart beats are more present - I can feel them in my chest, almost like I have worked out except my heart rate is normal. 


So my question is could the two drops that the holtor caught be a fluke due to stress from an argument? How often do beats drop with a 2nd degree block? I am worried I may have to have a pacemaker in the future and I am only now 27 years old so this worries me. Thank you for anything you can provide to this thread!


Second degree heart block Type-1 (Wenckebach)

by AgentX86 - 2021-01-02 00:45:54

Mobitz-I is usually a pretty benign electrical problem and often reverses itself.  There are a numer of causes, like meds, illnesses, and even dehydration. OTOH, MI is also a cause, which can be more serious. Your cardiologist will probably want to investigate further.  Unlike Mobiz-II, it doesn't usually degrade further into third degree block.  Since it doesn't often degrade further a pacemaker probably isn't likely in your immediate future.  If you're very symptomatic and it affects your quality of life a pacemaker may be necessary but QOL problems/fixes are really batter's choice.  Only you can say how it affects your life.

Yes, being upset can exacerbate the problem.  When you're stressed all sorts of biological processes get turned on.  It's the natural fight or flight response. Adrenaline does all sorts of wacky things to the body and priming the heart for action is one of its main purposes.  With that goes an increase in blood pressure and all sorts of other biological changes take place.  This is also a reason that breathing exercises work so well.  They calm the body, turning off the FoF response, reducing the adrenaline, causing  the body to "chill out" from its heightened state. 

Trick:  If you want to reduce your BP before the doctor takes it, five or ten slow, deep breaths will drop it significantly. It also counteracts the increase that happens when you walk from the waiting room to the examination room and the nurse takes your BP before you get back to the resting state (a bad practice but done all too often).

2nd Degree AV Block

by Smorris1993 - 2021-01-02 01:34:13

Thanks for your response, I am not sure of a direct way to comment back. My apologies!


I have 2nd degree according to my cardiologist, so I suppose that may or may not degrade further. I just find it odd to diagnose me with only 2 occurances, back to back, and nothing else during a 48 hour period. Are there are rules, expectations, etc. As to how often the drops occur in 2nd degree? 


Depending on what the 2 week holtor shows, I may get a second opinion. While there is nothing they want to do right now about the block, I cannot take certain meds because it may slow my heart rate. Given my age and no prior health problems that may point to a heart problem (other than my fathers poor heart health), it is just such a shock to me that I have this condition at my age. It has been almost a year since this diagnosis and, while it has not really changed anything in my life, I struggle to come to terms with having something wrong with me at my age that can progress into something more serious in the future. I just didn't think I would have to entertain a situation like this at this point in my life. 

2nd Degree Heart Block

by AgentX86 - 2021-01-02 14:03:32

Yes, wait for the results of your two week holter to decide where to go next.  In any case don't borrow trouble.  It won't help you one bit to stress over the results.  It's going to be what it is, then figure out where to go.  Worrying about it now won't help anything.  Yes, easy to say but it is my attitude and keeps me sane.  There is no point in looking back, either. Your only question should be "Where do I go from here?".


by Tracey_E - 2021-01-03 08:52:53

To echo Agent, don't borrow trouble. I know it's easy to jump to conclusions and think about the worst, but one step at a time. By definition, 2nd degree block is intermittent so yes, you can have it and it only happens once in 48 hours. For now, wait to see what the longer monitor shows. 

A very intermittent 2nd degree block would be watched, not paced, unless you were more symptomatic or your rate got very low.

Stress can aggravate an underlying problem but I don't believe it can cause block to show up on a monitor. 

Last, getting a pacer is not the end of the world. I got my first one at 27 but we have members who got it at birth and are thriving. I'm 54 now so have had it for half my life. I had 3rd degree block and my rate was way too low to be at all active so I actually should have had it earlier than 27. I'm healthy and active, have two grown kids, had a recent echo and stress test and passed both with flying colors. I do Crossfit and run, hike or ski most vacations. No one looks at me and sees a heart patient. Most of the time I forget it's there. But one step at a time! You are a long way from being paced. Right now it's just a curiosity to be watched. 

feel the beat

by dwelch - 2021-01-14 20:37:22

Like Tracey_E and others I have CCHB (complete, from birth).  I got my first pacer at 19, but should have had it earlier than that.  It ain't no thing.

By the time I got it I could feel every beat, and when I woke up with my first one that was gone, a disturbing empty feeling.

So my only comment is the beats you feel sometimes might be the heart block.  But they could also be response to the movie you are watching too, stress or happiness or whatever...

I will defer to Agent and Tracey otherwise on this one.  If you join the club you join the club if you dont you dont.  Find a doc you trust and trust the doc you find (go with what they prescribe).  A pacer at 2 or 7 or 27 is not a big deal.  I have leads older than you, I have been paced for 33 years. 

Even if you do not get a pacer, folks here have a combined wealth of knowledge and can keep talking you through what is going on or what the doctor is saying.  Definitely keep going to the doctor once or twice a year (if possible during covid but certainly after) or whatever they prescribe until this is completely gone or forever if it doesnt go away.  And dont be a stranger.  Not everyone needs a pacer and depending on how this turns out you can be the voice of reason for those that have conditions that might not warrant an immediate jump into having a device.  

If you do not have confidence in the doctor, your life is more important than their feelings, move on try another or few and select from that.  I have had one bad one but otherwise they have been really good.  Between moving and how insurance works I have had a handful now, but stick with the ones I like.  I have retired at least one and will no doubt retire the doc I am with now if I am able to stay here and keep seeing her until that point...So you come first if the doc cant communicate with you in a way that you need even if they are a great doctor otherwise, or you just dont trust them, or they dont commicate at all and talk over you to the nurse or scheduling people without consulting you on the next procedure.  Move on.

find a doc you trust, trust the doc you find.

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