# Out of Sync: A Report of Complete Heart Block

## TL;DR

This report describes a 79-year-old man with complete heart block and preserved heart function who was successfully treated with a pacemaker.

## Contribution

The novelty lies in presenting a rare case of complete heart block without systolic dysfunction or ischemia, successfully managed with pacemaker implantation.

## Key findings

- Echocardiography showed preserved systolic function despite complete heart block.
- Coronary artery disease and acute ischemia were ruled out as causes of the condition.
- Pacemaker implantation resolved the patient's symptoms and stabilized heart rhythm.

## Abstract

Complete heart block is a serious cardiac conduction condition marked by the inability of electrical impulses to propagate from the atria to the ventricles. This disorder causes an absence of coordination between the upper and lower chambers of the heart, resulting in various symptoms and possible problems. Complete heart block, also known as third-degree atrioventricular block, is a more severe form of this illness compared to first and second degree. This report describes a 79-year-old man who experienced a rare presentation of complete heart block. The patient had a preexisting condition of hypertension and had been having episodes of dyspnea for the past few months. Although the patient experienced these symptoms, echocardiography did not reveal any evidence of diminished ejection fraction, indicating that the systolic function was preserved. A left cardiac catheterization procedure was conducted, which showed non-occlusive coronary artery disease. Troponin levels were within normal limits, ruling out an acute ischemic event. This finding eliminates the possibility of severe ischemia factors contributing to the patient's condition. An extensive examination of the patient's medication history showed the absence of any drugs that could have caused the total heart block. The decision was reached to proceed with the implantation of a permanent pacemaker. The pacemaker was effectively inserted, resulting in the elimination of the patient's symptoms and stabilization of his heart rhythm.