What Is the Treatment for a Bifascicular Block?

Maggie J. Hall
Maggie J. Hall
An increase in physical exercise may help prevent a bifascicular block from progressing.
An increase in physical exercise may help prevent a bifascicular block from progressing.

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.

A change in diet may help prevent the progression of a bifascicular block.
A change in diet may help prevent the progression of a bifascicular block.

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.

Losing weight may help prevent the progression of a bifascicular block.
Losing weight may help prevent the progression of a bifascicular block.

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.

Antihypertensive medications may be prescribed to reduce cardiac stress.
Antihypertensive medications may be prescribed to reduce cardiac stress.

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.

An angioplasty may be performed to treat a bifascicular block.
An angioplasty may be performed to treat a bifascicular block.

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.

Symptoms of a bifascicular block may include lightheadedness.
Symptoms of a bifascicular block may include lightheadedness.

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.

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Discussion Comments

anon353877

I have been diagnosed with bi-fascicular block with a history of syncope. (thrice in two years). My angio, EPS and echo are normal. HV is 65ms. Doctors are advising PPM. I am otherwise very active. Is there any possibility of treating the problem with physical exercise and diet control without going for PPM?

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    • An increase in physical exercise may help prevent a bifascicular block from progressing.
      An increase in physical exercise may help prevent a bifascicular block from progressing.
    • A change in diet may help prevent the progression of a bifascicular block.
      A change in diet may help prevent the progression of a bifascicular block.
    • Losing weight may help prevent the progression of a bifascicular block.
      Losing weight may help prevent the progression of a bifascicular block.
    • Antihypertensive medications may be prescribed to reduce cardiac stress.
      Antihypertensive medications may be prescribed to reduce cardiac stress.
    • An angioplasty may be performed to treat a bifascicular block.
      An angioplasty may be performed to treat a bifascicular block.
    • Symptoms of a bifascicular block may include lightheadedness.
      Symptoms of a bifascicular block may include lightheadedness.
    • A bifascicular block may result from damage caused by a heart attack.
      A bifascicular block may result from damage caused by a heart attack.
    • Some patients who experience irregularities in their heart rhythm require the assistance of a pacemaker.
      Some patients who experience irregularities in their heart rhythm require the assistance of a pacemaker.
    • High blood pressure can be a contributing factor to bifascicular block.
      High blood pressure can be a contributing factor to bifascicular block.