2nd Degree Heart Block and exercise

[ismist1]

I have been diagnosed with Morbitz type one, second degree heart block (Wenckebach). In addition to the dropped beats, I also have a slow heart rate (Bradycardia), but no severe symptoms (e.g. syncope). I have had a stress test, EKG, halter monitor and echocardiogram. After all these tests, the best information I got from my doctors is "you're fine." I was given no reason for the heart block. Just a pat on the back and shown the door.

I should note that my symptoms only become a problem during periods of increased cardio health. That is, in the spring and summer when I am more active (biking), my heart experiences heart block at rest. It gets to the point that I stop exercising to get the symptoms to go away. This is a huge problem. I'm supposed to exercise to increase heart health, but doing so seems to make my heart less effective.

What should I do? I don't want to be one of those people that constantly runs up his medical premiums by repeatedly going to the doctor for reasons of anxiety, but I don't feel I have all the answers. I have had this problem since I was a little kid, and want to know why. Most importantly, I want some assurance that it won't progressively get worse, with me dropping dead because of some "new development" in my heart's disease. This is all scary stuff...

[goal_dd]

hi i have the same condition too,though my story is a bit different..i underwent a cardiac ablation procedure to treat a very annoying arrhytmia and during the procedure my av node got damaged resulting in second degree type 1 block(with occasional periods of complete block and bradycardia at rest). i wore a loop recorder for 5 years which basically shown that my condition didnt change during these years..im 39 too and i love excersise, though just like you i feel some discomfort sometimes when my heart starts to drop beats or slows down during the most intense part of excersing(funny how it slows down during excertion but as i stop, the hr gradually increases). im 39 too btw(i think you are my alter ego lol) and i ll meet my EP in some days..we discussed the possibility of getting a pacemaker  but he told me exactly the same they told you..i cant make up my mind either honestly cause im sure the pacemaker would massively improve my condition and i could be able to push as much as i i used to do before all this but at the same time all the risks,precautions and discomfort(changing the leads,the battery, undergo the surgery every 8 years and so on) maybe outweigh the pros of getting the pm..what your event monitor showed?  

[VCJohnson]

Sorry, I just reread your first post and saw that your diagnosis is type 1, not type 2.  So, you do not have an immediate risk of complete heart block and probably do not need a pacemaker, unless your block condition progresses to type 2 or your HR drops become more frequent.

[VCJohnson]

I, too, have 2nd degree, Mobitz type 2 heart block.  My blocks always occurred during intense exercise.  My EP thinks that I was born with it.  I'm 60 now and remember having difficulty taking  a "complete" deep breath even back when I was a child.  My diagnosis of 2nd degree, type 2 wasn't diagnosed until about 2.5 years ago.  I've been an avid runner and cyclist since I was about 21 and experienced heart rate drops and a "dead leg" feeling only during exercise, since my 20's.  My resting pulse rate was about 48 back then, and even got lower in more recent years, perhaps Bradycardia, but that hasn't been diagnosed.  My Cardiologist, 2.5 years ago, said that if I didn't get a pacemaker, I would have to stop all exercise. I got the pacemaker implant and the HR drops have decreased to about one per 3 months now, about the same frequency as when I was in my 20's.  Immediately prior to the pacemaker implant, the heart rate drops were occurring several times per week.  Getting my pacemaker properly adjusted was very difficult and I changed Cardio EPs three times, involving very much of trial and error on their part.

I've read that 2nd degree, type 2 can eventually become 3rd degree and a complete heart block.  Complete heart  block can cause sudden cardiac death.  That is why I agreed to the pacemaker implant.

If I were you, I'd get a 2nd opinion from another Cardiac Electro Physiologist to confirm your 2nd degree, type 2 diagnosis and also whether or not he recommends a pacemaker implant.  I've read that in the future pacemakers will be wireless, no leads, with only an electrode implanted into a paced heart chamber.  Also, the future pacemakers will be much smaller and implanted inside the heart via a catheterization procedure.  Good luck.

[ismist1]

No, I never really figured out what is going on. I have been told by cardiologists that this is just one of those things that really doesn't have a concrete answer. I am most perplexed by the inability to explain why I feel discomfort, as most people with this form of heart block don't even notice it. We discussed the possibility of using a pacemaker, but my cardiologist was really against it. I am only 39 years old, and the electrodes need to be replaced every 7 years or so. I was told they typically snip them off and attach new ones to the heart, so after a period of time the heart becomes a sort of "junkyard" of electrodes, which eventually require a more elaborate surgery to clean up. Overall, the risk wasn't gonig to be worth the reward.

I have recently been experiencing new arrhytmias, and am now wearing a 30 day event monitor. We'll see how that goes...

[sthrasher1]

I have the samething going on. Did you ever figure anything out?

[Barbmag]

If it were me, I would prob get a second op and also ask all of these excellent questions of the doctor. I usually make notes to take with me so that I remember everything that I want to ask and ask I do!!! I do not leave the office until I understand what the doctor is telling me.
For me, my cardiologist has never been able to tell me why I have an electrical prob with my heart. I guess there are some things that even they don't have answers to which is v frustrating for me. I try to learn all that I can tho, online, on this forum and yes, from my doctors!! I am paying them to spend time with me so I do not feel bad at all when I ask a lot of questions!
Good luck!