Maybe you are looking at the title to this post and saying: "What in the world is this woman talking about? There must be a misspelled word or two in the title right? I thought she had heart failure? What is conduction? Didn't Melanie used to play a clarinet and bassoon? Is she now pursuing a career in leading an orchestra." While I do love music, nope - I'm not going to be on stage wielding a baton anytime soon.
So welcome to my world where on a fairly frequent basis, I get to review medical paperwork with random medical terms that are unintelligible to the vast majority of the inhabitants on this earth. Most normal people would probably just set the medical report aside and leave the technical stuff to the doctors. But I have never been accused of being normal, and I'm proud of it. And I have always believed that the best way to manage my chronic condition is to know everything I can about the condition and how it impacts me and my heart.
When I encounter these strange terms, it makes me almost grateful for more simple terms like “heart failure”. Even though heart failure is a dreadfully inaccurate term, at least I have a fighting chance to be able to spell it and pronounce it. Even though heart failure is a dreadfully inaccurate term, I can at least explain to folks what I think it means.
Conduction Disorder Mobitz Type II was a diagnosis that appeared on my medical report in 2015. When I recently came across this 2015 report, I thought perhaps it would be a good topic for a blog post. But then I realized that my ability to articulate what this meant was very limited. I hoped that the internet would help me find words to fill my post. Alas, I quickly learned that finding an easy explanation was going to be a bit of a challenge.
Lest you think I am exaggerating, let me give you just a sample of a British Heart Journal abstract I found on the NIH website. The abstract is entitled “Mobitz II AV block within the His bundle, with progression to complete heart block”. Here is just a short excerpt:
I was totally clueless as to what this excerpt meant other than the occurrence of syncopal episodes was an indication that this woman likely was fainting at the drop of a hat. I had no idea why she had “His” bundles rather than “Hers” bundles. It is also a mystery to me why a “rhythm” was able to escape this nightmare, but our poor female patient could not escape.
But after some research I think I can now break down for us what the Mobitz type II conduction disorder is. I went to one of my best sources, the American Heart Association, and found that they have an entire section devoted to conduction type disorders. (Yes, believe it or not, there are a number of these disorders). Apparently Mobitz Type II is also referred to as Second Degree Heart Block (which I think is also connected to the term AV block). Here is what the AHA says:
When it comes right down to it, the most critical pieces of information you can glean from this are in the first sentence and the last sentence: First, your heart’s electrical signals can’t get where they need to go, and the result is you’re your heart is in serious trouble. Second, a piece of hardware known as the pacemaker can rescue you from the depths of despair.
Of course, I had to figure out who or what Mobitz and Wenckenbach were. Mobitz was a Russian German physician. Wenkenbach was a Dutch anatomist. I also decided to google the term “His bundles”. Believe it or not, there is a definition on the Merriam Webster website for this term. It is also named after a person. Wilhelm His was a German cardiologist. In 1893 he defined the atrioventricular bundle. The bundle is defined as: “a slender bundle of modified cardiac muscle that passes from the atrioventricular node in the right atrium to the right and left ventricles by way of the septum and that maintains the normal sequence of the heartbeat by conducting the wave of excitation from the right atrium to the ventricles.”
I also decided to look up the medical definition of the term “heart conduction system”. According to medicinenet.com, it means: “The electrical conduction system that controls the heart rate. This system generates electrical impulses and conducts them throughout the muscle of the heart, stimulating the heart to contract and pump blood.”
So we just reviewed a medical term (or actually a bunch of medical terms) with lots of serious consequences. So why was this Conduction Disorder Mobitz Type II used to describe the state of my heart health in 2015? Well, if you will recall, in late 2012 and the first three months of 2013, I lived through a period when I was blacking out, getting dizzy and just feeling like someone had removed the batteries from my energy compartment.
Obviously my electrophysiologist concluded that my heart was not beating effectively, to the detriment of all the rest of my bodily functions. It probably wasn’t a hard thing to diagnose, since in addition to my pronounced symptoms, there was also a holter monitor report that at some junctures started to look to me like I was flat-lining.
I believe the term AV block might be used more often than Mobitz Type II. In fact, most of my reports have used the term Atrioventricular Block, second degree. AV block of course refers to the fact that the electrical signal impulses are being blocked, and thus are not being properly conducted between the atria and the ventricles. The pacemaker seems to be a common treatment for this condition. So what happens after you get the pacemaker? Let's do a short recap.
Your cardiologist may recommend some restrictions about the types of exercise you can participate in (such as contact sports). I got the advice that I could lift light weights, but no power lifting! In general, a pacemaker will not seriously restrict your ability to take part in sports and leisure activities.
Your cardiologist will want to periodically check your pacemaker to make sure that it continues to meet your needs. My original pacemaker, as well as my current device is checked using a special monitoring system that uses a phone to send information from the device to a heart monitoring center.
If you have a pacemaker or CRT device, you should avoid close contact with magnetic devices and any device that sends out an electrical field. When traveling, tell airport security screeners that you have a pacemaker or CRT device, and carry a card that states the type of device you have. It is important to tell all of your doctors, your dentist and other healthcare providers that you have a pacemaker or CRT device. This is because some medical procedures, such as magnetic resonance imaging (MRI), can interfere with pacemakers and CRT devices in a very bad way.
I have not seen the terms “Mobitz Type II disorder” or “AV block” on any recent medical reports. This has led me to the conclusion that my CRT device (which now includes both a pacemaker and a defibrillator) has resolved the block between the atria and the ventricles. Even though my heart failure is the result of a dilated cardiomyopathy that has made my heart weaker, the conduction system in the heart appears to be back in business.
Of course, reading up on these medical terms has made me even more curious, if that is possible. So which came first in my heart decline - was it the dilated cardiomyopathy, the AV block or the heart failure. Or did all three just gang up on me at the same time? Or is a chicken and the egg situation, which the Cambridge English dictionary defines as impossible to say which one of two things existed first and which caused the other one.
I may continue to chase this down even though I know I may never find an answer. Why - because researching these odd terms has had a positive impact on me. It makes me realize how much my heart was messed up, and how science has been able to correct at least some of the damage. As always, preparing these posts has made me feel fortunate for treatment that improves my condition.
So let me just close by saying I am happy that there is nothing blocking the optimism from traveling from my brain and spirit directly to my weak little heart!
Melanie discovered that she had heart failure in 2013. Since that time, she has been learning how to live with the condition, and how to achieve balance and personal growth.