Question
My heart has been skipping and I'm feeling dizzy. I went in for testing and was diagnosed with second degree heart block. The doctor said that if it goes to third degree, he might suggest a pacemaker. What can I do to avoid moving to third degree?
Answer
When the heart beat starts to slow down, or when the conduction starts to block every so often, sometimes it is because a medication is stressing the heart's electrical system. If there are no medications to account for this slowing or skipping, however, then there isn't much that can be done for this condition, other than a pacemaker. The problem is more about your electrical wiring showing some wear and tear from everyday life.
A second degree heart block comes in two different types. One type is quite safe, and you can watch and wait for more slowing before worrying about a pacemaker. I'm assuming this is what you have, since your doctor has not insisted on a pacemaker after seeing you. The other type, however, can be a bit more concerning. When someone has what we call "Type 2" second degree heart block, we typically will not wait for third degree heart block before we strongly recommend a pacemaker. It is important that you have your doctor continue to follow you closely, so that any worsening of your heart block can be picked up in a timely manner.
Having a pacemaker implanted is a scary thought to many patients. It can take some time to get used to the idea. Overall, it has become a routine procedure for many centers and should be performed with very little risk. The procedure itself only takes one to two hours and is usually done with you completely sedated, so you won't remember it. Patients are routinely watched overnight in the hospital before going home. After some activity restrictions to help the pacemaker procedure site heal properly, there are very few restrictions you have to worry about.