What is the primary treatment approach for a third-degree AV block?

The primary treatment for a third-degree AV block, also known as complete heart block, involves the insertion of a permanent pacemaker. This intervention is necessary because, in third-degree AV block, there is a complete dissociation between atrial and ventricular contractions. This results in significant bradycardia or may even lead to periods of asystole, putting the patient at risk for serious complications including syncope and sudden cardiac death.

A permanent pacemaker provides electrical stimulation to the heart, ensuring coordinated contractions and thus maintaining an adequate heart rate and rhythm. While temporary pacing and medication might be part of the initial management, especially in acute scenarios where a permanent pacemaker cannot be immediately placed, they do not represent the definitive long-term solution.

Antibiotic therapy is not applicable in the management of AV block, as it is not caused by an infection. Similarly, cath lab interventions, which typically involve procedural treatments for coronary artery disease, are not relevant to the treatment of a third-degree AV block. Therefore, permanent pacemaker insertion is recognized as the most effective and standard treatment approach for this condition.