Third degree AV block natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2] Raviteja Guddeti, M.B.B.S. [3] ; Aditya Ganti M.B.B.S. [4]


The majority of the patients with complete heart block do not recover spontaneously. Untreated complete heart block is associated with high morbidity and mortality. Patients with complete heart blocks are prone to decreased perfusion related to symptomatic bradycardia and decreased cardiac output. Common Complications of third-degree AV block include sudden cardiac death due to asystole, syncope, and musculoskeletal injuries secondary to fall after syncope. The prognosis of the third-degree heart block is most likely dependent on the patient's underlying disease burden and severity of the clinical presentation on arrival. Patients treated with permanent pacemakers have an excellent prognosis.

Natural History, Complications, and Prognosis

Natural History




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  2. Merchant FM, Hoskins MH, Musat DL, Prillinger JB, Roberts GJ, Nabutovsky Y, Mittal S (June 2017). "Incidence and Time Course for Developing Heart Failure With High-Burden Right Ventricular Pacing". Circ Cardiovasc Qual Outcomes. 10 (6). doi:10.1161/CIRCOUTCOMES.117.003564. PMID 28630373.
  3. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO (January 2013). "2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society". Circulation. 127 (3): e283–352. doi:10.1161/CIR.0b013e318276ce9b. PMID 23255456.
  4. Strasberg B, Kusniec J, Erdman S, Lewin RF, Arditti A, Sclarovsky S, Agmon J (July 1986). "Polymorphous ventricular tachycardia and atrioventricular block". Pacing Clin Electrophysiol. 9 (4): 522–6. doi:10.1111/j.1540-8159.1986.tb06609.x. PMID 2426671.
  5. Tanaka Y, Yamabe H, Yamasaki H, Tsuda H, Nagayoshi Y, Kawano H, Kimura Y, Hokamura Y, Ogawa H (June 2009). "A case of reversible ventricular tachycardia and complete atrioventricular block associated with primary cardiac B-cell lymphoma". Pacing Clin Electrophysiol. 32 (6): 816–9. doi:10.1111/j.1540-8159.2009.02372.x. PMID 19545348.
  6. Kosmidou I, Redfors B, Dordi R, Dizon JM, McAndrew T, Mehran R, Ben-Yehuda O, Mintz GS, Stone GW (May 2017). "Incidence, Predictors, and Outcomes of High-Grade Atrioventricular Block in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention (from the HORIZONS-AMI Trial)". Am. J. Cardiol. 119 (9): 1295–1301. doi:10.1016/j.amjcard.2017.01.019. PMID 28267964.
  7. Harikrishnan P, Gupta T, Palaniswamy C, Kolte D, Khera S, Mujib M, Aronow WS, Ahn C, Sule S, Jain D, Ahmed A, Cooper HA, Jacobson J, Iwai S, Frishman WH, Bhatt DL, Fonarow GC, Panza JA (December 2015). "Complete Heart Block Complicating ST-Segment Elevation Myocardial Infarction: Temporal Trends and Association With In-Hospital Outcomes". JACC Clin Electrophysiol. 1 (6): 529–538. doi:10.1016/j.jacep.2015.08.007. PMID 29759406.

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