What is the immediate treatment for complete heart block?

The immediate treatment for complete heart block involves addressing the critically slow heart rate and potential hemodynamic instability associated with the condition. Transcutaneous pacing is the most effective and direct method to restore an adequate heart rate in a patient experiencing complete heart block.

Complete heart block, also known as third-degree heart block, results in the dissociation between atrial and ventricular activity, leading to a significant reduction in cardiac output. Patients may present with symptoms such as dizziness, fatigue, or syncope due to this compromised circulation. Transcutaneous pacing applies electrical impulses through the skin to stimulate the heart to contract at a faster rate, thus improving cardiac output and stabilizing the patient while more definitive treatments, such as permanent pacemaker placement, are arranged.

Defibrillation is primarily indicated in cases of ventricular fibrillation or pulseless ventricular tachycardia, not for heart block. Intravenous epinephrine may be used in cases of severe bradycardia or cardiac arrest, but it does not address the fundamental issue of complete heart block as effectively as pacing. Vasopressors can help to increase blood pressure but would not correct the underlying problem of the block itself.

Therefore, transcutaneous pacing is the preferred and immediate action when faced with complete heart