What is the definitive therapy for complete heart block?

What is the definitive therapy for complete heart block?

• A. Temporary pacing only
• B. Vagal maneuvers
• C. Permanent pacemaker
• D. Observation

Answer: (C)

Complete heart block means the impulses from the atria aren’t conducted to the ventricles, so the ventricles beat on their own slower escape rhythm. This mismatch can drop cardiac output and cause symptoms like syncope or heart failure, and it carries a risk of sudden death if not corrected. The definitive, long-term fix is a permanent pacemaker, which provides reliable pacing of the ventricles (and can coordinate with the atria in dual‑chamber devices) to restore a stable heart rate and rhythm. Temporary pacing can be used to bridge the patient in acute situations while a permanent device is being placed, but it is not a lasting solution. Vagal maneuvers aren’t helpful here; they affect atrioventricular conduction and can worsen bradycardia, not correct a block. Observation is inappropriate because the block can lead to significant hemodynamic compromise.

Complete heart block means the impulses from the atria aren’t conducted to the ventricles, so the ventricles beat on their own slower escape rhythm. This mismatch can drop cardiac output and cause symptoms like syncope or heart failure, and it carries a risk of sudden death if not corrected. The definitive, long-term fix is a permanent pacemaker, which provides reliable pacing of the ventricles (and can coordinate with the atria in dual‑chamber devices) to restore a stable heart rate and rhythm. Temporary pacing can be used to bridge the patient in acute situations while a permanent device is being placed, but it is not a lasting solution. Vagal maneuvers aren’t helpful here; they affect atrioventricular conduction and can worsen bradycardia, not correct a block. Observation is inappropriate because the block can lead to significant hemodynamic compromise.