Abstract
Introduction: Complete Heart Block (CHB) occurs when the electrical signals can’t pass normally from the atria, the heart’s upper chambers, to the ventricles or lower chambers. This condition can develop because of congenital or secondary to cancers, myopathies or heart ischemia, infectious or endocrinological disorders and it needs comprehensive work-up to be excluded.
 Background: In the United States, the prevalence of third degree atrioventricular (AV) block that is complete heart block is 0.02 percent. The prevalence of third-degree AV blocks worldwide is 0.04 percent. With advancing age, the rate of AV conduction defects rises, resembling the age-related incidence of ischemic heart disease.
 Case Presentation: A case of 68 year old female admitted in cardiac ward on date 11 january 2021 with the chief complaint of breathlessness on exertion, restlessness, chest pain and loss of appetite since 2 month. The patient is a known case of hypertension since 5 year, Ischemic heart disease sine 1 year. after physical examination and other investigation like ECG, electrocardiogram the she diagnosed as a complete heart block with third degree.
 Interventions: The patient was treated by placing permanent pacemaker on dated 18 january 2021. After that started the antibiotic like inj. targocid, inj. ceftriaxone, tab. linezolid, tab. orabest, tab. telmed H and taking also the anticoagulant therapy. She also under the care of cardiologists and monitor by hourly, also monitor the electric activity of pacemaker. Provide health education about healthy diet, life style modification, yoga and exercised, control over blood pressure and regular follow up.
 Conclusion: This study mainly focusing on the medical and placement of permanent pacemaker which help the heart to do their normal function and passing a normal electrical signals throught the heart rhythm. A good nursing care needed for the patient who have complete heart block and surgical implementation in permanent pacemaker for continue monitored, no any complication can occur during or after pacemaker implantation. the patient response for the treatment was good and she recover rapidly.
Highlights
Complete Heart Block (CHB) occurs when the electrical signals can’t pass normally from the atria, the heart’s upper chambers, to the ventricles or lower chambers
The patient is a known case of hypertension since 5 year, Ischemic heart disease since1 year
Blood investigation : In complete blood count (CBC):Hemoglobin is 12.2 mg/dl(11-13mg/dl), mean corpuscular hemoglobin concentration is 32.6 g/dl, Mean corpuscular volume (MCV) is 90 fl (78-98 fl ), total RBC count is 4.52 m/ul, WBC is 10200 (4500-11,500 k/ul),platelet count is 239,000/ml (150,000 to 450,000 ), Hematocrit (Hct) Levels is 35.7 % (37 %-47 %), monocytes is 04 %(00-15%), Granulocytes is 74 % and Lymphocytes is 30 %(20%-40%), red cell distribution width (RDW) is 12.9 (11.6-14.8), An ECG may reveal abnormalities in heart rhythm seen in the ECG before permanat pacemaker and after placement of permanat pacemaker the ECG shows normal findings
Summary
This work was carried out in collaboration among all authors. All authors read and approved the final manuscript. (1) Jurandyr Santos Nogueira, Federal University of Bahia, Brazil. (2) Walid Hammad, University Hospital Galway, Ireland
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