Treatment for bifascicular block depends on the contributing factors and any symptoms a patient may experience. Preventative measures or management of existing medical conditions may slow the progression of the condition. Patients not experiencing symptoms may only require periodic evaluation while individuals having underlying conditions require treatment that is more extensive.
The normal heart conduction pathway begins in the sinoatrial (SA) node of the right atrium. The impulse travels down to the atrioventricular (AV) node, located between the atria. The path continues downward to the bundle of His, which forms just below the AV node. Below this juncture, the path divides into left and right branches, or the Perkinje fibers, which supply impulses to the left and right ventricles. The left branch further extends into the anterior and posterior hemi-fascicles. Bifascicular blockages occur when impulses fail to travel to the right and either of the left branches.
Interrupted impulses toward the ventricles may not produce noticeable symptoms or may reduce the contracting ability of the lower heart muscle, causing a slower than normal ventricular heart rate. Patients may live for years without feeling different, or the condition may produce light-headedness and fainting. The bundle branch blocks might be a congenital heart defect, but disease processes often cause the condition. Coronary artery disease, hypertension or heart attacks are some of the contributing factors. Treatment for bifascicular block includes managing these conditions.
Health care providers might suggest lifestyle changes, as part of the treatment for bifascicular block, that may prevent the disease processes from progressing and aggravating the block. Alterations might include dietary adjustments, an increase in physical exercise, and weight reduction. Supplements or medications designed for cholesterol reduction, which reduce vascular inflammation and plaque development may also be recommended. Physicians commonly treat hypertension with diuretic medications that reduce excess body fluid. Antihypertensive medications reduce cardiac stress by interfering with chemicals that cause vascular constriction.
Individuals may experience bifascicular blockage, as part of the damage occurring after a heart attack. Cardiologists may use a combination of medications and treatments to improve circulation to the heart. Anigoplasty or clot-busting medications open blocked or narrowed vessels in the presence of vascular blockage. If permanent conduction interference occurs, physicians often recommend mechanical pacing devices.
Patients might experience bradycardia, or a slower than normal heart rate, which produces presyncope or lightheadness. They might also endure syncope, commonly known as fainting. These symptoms usually require that patients receive pacemaker implantation for treatment of bifascicular block. The battery-operated device ensures that at least one of the ventricles continues to contract at preset rhythms. Bundle block patients might also have the option of receiving cardiac resynchronization treatment (CRT). This implanted mechanical device regulates the contractions of both ventricles.