Heart Block

Many families find out their child has a heart block during a fetal echo before birth. Others find out shortly after birth or don’t find out until their child shows symptoms. A heart block affects the way electrical signals move in your child’s heart to keep it in rhythm. It may cause a weak heartbeat that doesn’t deliver enough blood.

Any issue affecting your child’s heart raises lots of scary questions. But they’ll all boil down to one: will my child be okay?

At UVA Health Children’s, we can offer your child the best heart care outcomes, both in the short term and the long term. In Virginia, we’re the only pediatric hospital that offers the full range of care for heart blocks. Our unique partnerships with hospitals around the state mean we can often bring world-class care to you, close to home. When that’s not an option, our Newborn Emergency Transport Service (NETS) can bring your child to us.

Heart Block Treatment at UVA Health Children’s

Often, we’re able to find a heart block through a fetal echo. This imaging exam allows us to look at your child’s heart before birth so we can make a delivery plan to treat your child quickly if needed.

How we treat a heart block depends on how severe it is. Your child may only need to be watched to see if a more serious issue happens. Or they may need a pacemaker to support their heartbeat.

Treatment Depends on the Type

A first-degree heart block means that the heart’s electrical signals are still being sent and received. They’re just a little bit slower. We’ll set up monitoring and do follow-up, but most likely won’t need to do any treatment early in life.

A second-degree heart block is more severe. The signals are slower. Most of the time, regular follow-up with a cardiologist is all that’s needed. But there may be some skipped heartbeats, and your child may have a slower-than-average heart rate. Very rarely, a pacemaker is needed.

A third-degree heart block is also called a complete heart block. And in children, it’s the most common form. In complete heart block, the electrical signal never reaches the lower parts of the heart.

Pacemakers for Children with Heart Block

Most children with complete heart block need a pacemaker.

When there is a problem with a heart’s signals or rhythm, pacemakers provide a regular signal. This new, strong signal keeps everything on tempo. That means your child’s heart works the way that it should.

Your care team will teach you how to feel for and keep count of your child’s pulse. This helps you know if everything is working while you’re at home.

During follow-up appointments, we’ll make sure your child’s pacemaker is working well. And we’ll talk about replacement pacemakers as needed.

Heart Block: Frequently Asked Questions

What does a heart block look like?

The symptoms of heart block depend on how bad it is and how old your child is. Symptoms can look like:

• Turning blue
• Fatigue and lethargy
• Not being able to eat

For older kids, they may have:

• Fainting
• Feeling lightheaded or dizzy
• Feeling short of breath
• Not being able to exercise

Will my child be able to do normal activities?

For the most part. Some activities, like contact sports, aren’t recommended for children with pacemakers. Also, because pacemakers are metal, things like metal detectors and MRI machines can be an issue.

But many of the things that used to affect older pacemakers, like microwaves and cell phone signals, no longer affect the newer models.

What caused my child’s congenital heart block?

Heart block is rare in children. Sometimes it occurs as part of another congenital heart defect. Sometimes it occurs due to a pregnant parent’s autoimmune disease, like lupus.

Can children acquire heart block?

Rarely, children can acquire a complete heart block through conditions like myocarditis. Once acquired, the treatment is the same.