Evidence Checklist: Atrioventricular Block (Heart Block)

ECG documenting AV block degree and typeCritical

Electrocardiogram confirming AV block type: first-degree (prolonged PR), second-degree (Mobitz I or II — Wenckebach), or third-degree (complete heart block). Mobitz II and complete block are higher severity.

Holter monitor or event recorder documenting conduction pauseCritical

24-48 hour Holter monitor or long-term event monitor documenting symptomatic pauses, syncope correlation, and ventricular escape rhythm.

Nexus opinion linking AV block to service ("at least as likely as not")Critical

A medical opinion connecting AV block to service-connected myocarditis, Lyme disease from service in endemic areas, cardiac surgery during service, or other in-service cause.

Exercise stress test with METs estimationCritical

Stress test documenting functional exercise capacity and heart rate response. METs level is a primary rating driver for cardiac conditions.

Pacemaker implant records (if applicable)

Documentation of pacemaker implantation for high-degree AV block. Pacemaker-dependent patients may be rated separately under diagnostic code 7018.

Syncope or presyncope documentation

Medical records or emergency records documenting syncopal episodes (loss of consciousness) or presyncope (near-fainting) caused by conduction pauses.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Completed DBQ Heart ConditionsCritical

Standardized form capturing ECG/Holter findings, METs, pacemaker status, and functional limitations from AV block.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.