Treating heart block 

Heart block usually only needs to be treated if it's causing symptoms (symptomatic).

However, most cases of acquired heart block need to be treated regardless of whether there are symptoms or not. This will usually be in cases of:

  • Mobitz type 2 second-degree heart block
  • third-degree heart block

First-degree heart block may not need to be treated. You may need to have a pacemaker fitted if you have second degree heart block (see below). If you have thrid degree heart block you'll need a pacemaker.

Due to the potentially serious nature of symptomatic heart block, if you experience a sudden onset of the symptoms of heart block, you should dial 999 to request an ambulance.

You'll be taken immediately to the nearest hospital.

Transcutaneous pacing (TCP)

Transcutaneous pacing (TCP) is a temporary method of pacing the heart in a medical emergency. It's used to restore your heartbeat to normal.

During TCP, pads are applied to the chest and electrical pulses are delivered through them to help restore your heart rate.

The procedure can feel uncomfortable so you may be given medication to sedate you (a sedative). This will make you feel drowsy so you have little or no awareness of what's going on around you.

Temporary transvenous pacing (TTP) is an alternative to TCP. It involves a tiny wire being fed into your heart and linked to an external pacemaker to restore your heart beat. As with TCP, this will be carried out under sedation.

Once your heartbeat has been stabilised, a permanent pacemaker may be recommended (see below).


A pacemaker is a small electrical device that produces tiny electrical signals that replace the function of your natural pacemaker.

Pacemakers are run by a small dry cell battery. They vary in size but most are around two-thirds the size of a credit card and about 5mm thick.

The pacemaker is connected to up to four wires that are fed into your heart through one of your veins. It's placed in the appropriate area of the heart using X-ray guidance. 

Read more about pacemaker implantation for more information about how they work and are fitted.

Page last reviewed: 21/08/2014

Next review due: 21/08/2017