Life Insurance with Atrioventricular Block or AV Block – Can you get it?


Can you get life insurance if you have an atrioventricular block?

Yes, you can, and we can help. Rates and risk classes available will be based on the type of block and your other underlying conditions. If you are dealing with an AV Block and no other complications, the top drivers of your life insurance rates will be the degree of the AV block and your age when you were diagnosed.

We understand AV blocks, bundle branch blocks and electrical heart blocks in general.  We know the life insurance companies that underwrite these risks, and we will partner with you to get you the best rates.

Get more information in this article about how Heart Block affects life insurance rates. Or, if you want to skip to the good stuff, fill out the quote form to the right.  Choose “Standard” as your health class and let us handle this process for you.

Here is a handy guide to this article, feel free to head directly to the section you need.


A heartbeat is a beautiful synchronized dance, and your heart’s electrical system is the conductor. This electrical system is fascinating and amazing, however, sometimes there are interruptions.

An Atrioventricular Block (sometimes called a Bundle Branch Block (BBB), or just Heart Block) is one of these interruptions.  AV Block occurs when there is a break in the normal heart signal that originates from the sinoatrial (SA) node and radiates into the heart muscle.

Heart block is fairly rare, occurring in about 1 percent of the population.  It is usually not lethal. They can be congenital or acquired, and in some mild cases, the condition can be reversible.


So if Heart Block is not lethal, and it’s rare, why do life insurance underwriters care?  Why is this considered a high-risk condition?

AV block puts a patient at a much higher risk for Atrial Fibrillation (AFib), pacemaker implantation, and overall mortality.  That’s why it is a concern to a life insurance underwriter.

Based on research conducted in 2009, patients with AV block had a 200% higher adjusted risk for AFib, they had three times as many pacemakers, and they had a 160% higher risk of death overall.

Types of Heart Blocks

The interrupted electrical signals can result in several abnormalities, including:

  • Left and right ventricles not pumping at the same time
  • Ventricular contractions that are slower than atrial contractions
  • Skipped ventricular contractions altogether

Here are some of the common diagnoses for Heart Block:

  • Incomplete right bundle branch block (IRBBB)
  • Left anterior hemiblock (incomplete) (LAHB)
  • Left posterior hemiblock (incomplete) (LPHB)
  • Complete right bundle branch block (CRBBB)
  • Complete left bundle branch block (CLBBB)
  • Bifascicular block

What causes Atrioventricular Block?

AV Block is sometimes present at birth, however that is rare.  More often, risk factors such as aging and underlying cardiovascular conditions lead to acquired Heart Block. Several disorders that lead to AV Block are:

We list all of these causes as a formality because most often coronary artery disease is the culprit. Coronary artery disease accounts for about half of all cases of BBB.

What does the life insurance company need to know about your AV block?

The insurance company will also likely ask you these questions:

  • What is your normal, resting heartbeat?
  • Do you have other heart issues like congenital heart failure, coronary artery disease, valvular heart disease or atherosclerosis?
  • Do you have a pacemaker?
  • When were you diagnosed?
  • Are you a smoker?
  • Are you taking any medications for your heart, like beta-blockers or ACE inhibitors?


Insurance companies use the cause of your Heart Block as the main determining factor regarding whether you’ll get life insurance. Underwriters will carefully look at the underlying cause to assess your risk as an insurance applicant.

Next, your age and the stability of your condition are determining factors. Many patients have stable BBB. There are no underlying cardiovascular conditions or complications, and patients have no symptoms. Many of these cases are underwritten as “standard”, and younger people with stable BBB might even be classified as “preferred.”

Insurance companies use the following information to determine your insurance rating:

  • Type of Heart Block (your diagnosis)
  • How long your bundle branch block has been present
  • Detailed symptom list (chest pain, heart valve disease, congenital heart disease or defect, high blood pressure, etc.)
  • Most recent ECG results
  • Other cardiac tests, including stress tests.
  • Medications list

The underlying cause of the branch block is a crucial factor in determining the rating. For example, cases of BBB caused by blockage of the impulse-conducting fibers in the left heart chamber are more severe so you will likely get a lower rating.


If you are dealing with a Heart Block and no other complications, the top factors for your life insurance rates are the age of diagnosis, and the degree of the AV block.

Age of Heart Block Diagnosis and Life Insurance

Here is the insurance rating breakdown by age; insurance companies look at when you were diagnosed —under 40 or over 40.

People 39 and under:

  • A standard rating is possible for incomplete right BBB and left anterior or posterior incomplete hemiblock
  • Moderate Table rating for complete right or left bundle branch blocks (CRBBB)
  • Moderate Table rating for bifascicular block (complete right bundle branch block with left hemiblock

If you’re over 40, the following conditions usually have a standard rating:

  • Incomplete right bundle branch block (IRBBB)
  • Complete right bundle branch block (CRBBB)
  • Left anterior hemiblock (incomplete) (LAHB)
  • Left posterior hemiblock (incomplete) (LPHB)

These more serious Heart Blocks have mild to moderate substandard rates:

  • Complete left bundle branch block (CLBBB)
  • Bifascicular block

Degree of AV Block and Life Insurance

There are three-degree classifications of AV or Heart Block. We think this is a handy way to remember them, borrowed from our friends in nursing school:

heart block life insurance av block life insurance with atrioventricular block term life insurance


First-degree Heart Block is the least severe. Electrical signals are slower as the signal moves from the top atria to the lower ventricle chambers. Many people with first-degree Heart Block never have symptoms and don’t require treatment.

First degree blocks are “incomplete” and are usually classified as a standard rating.

You may get a preferred rating with a very mild first-degree case. People under age 39, with no symptoms or other heart issues, and in very good health otherwise can earn this rating.

Life insurance rates with a first degree AV Block: Check the P-R interval from the ECG

The P-R interval shows up on an ECG. This interval measures how long it takes an electrical impulse to travel between the sinoatrial node to the atrioventricular node. SA to AV is the P-R interval.

A normal P-R interval is somewhere between 0.12 and 0.20 seconds.

If your P-R interval is less than 0.29 seconds?  There will be no rating at all.

P-R intervals 0.30 seconds and higher will qualify for mild substandard rates, though you could lower those rates with a recent treadmill stress test.

Second-Degree AV Block

People with second-degree Heart Block have much slower electrical signals between the atria and ventricles—much more so than in first-degree Heart Block. In some cases, the electrical signals don’t even reach the lower chambers of the heart.

When this occurs, the ventricles don’t contract and blood is not pumped to the lungs or body. There are two subtypes: Mobitz type I and Mobitz type II.

Mobitz Type I means that with each heartbeat, signals are more delayed. After a while, the heart skips a beat. This type of block is called Wenckebach’s block. Dizziness sometimes occurs, as does shortness of breath and even fainting spells.

Despite the symptoms, Mobitz Type I is a much less serious Heart Block than Mobitz type II.

Mobitz Type II Heart Block is also characterized by some signals never reaching the ventricles, but the pattern is much more irregular than in Mobitz I.

This type is more severe but much less common.

Second-degree blocks are considered moderate risk for life insurance and are priced accordingly. There are exceptions, though. Very mild, asymptomatic cases of Mobitz I with a normal heart rate can get a standard rating.

More than likely, insurance companies will likely give a mild to moderate substandard rating for Mobitz type I or Mobitz Type II with a pacemaker.

More severe cases of either Type I or II might be rated “moderately substandard” if there is difficulty breathing, chest pain, or erratic symptoms.

Traditional life insurance can be denied for a second-degree AV if it is severe or with an unknown cause.

Third-Degree Atrioventricular Block

In a third-degree Heart Block (or complete AV block) none of the electrical signals from the heart’s sinoatrial node ever reach the ventricles. The ventricles contain mini-backup systems that create their own electrical signals to contract the muscle, and they fire into action when complete Heart Block occurs.

The ventricle signals are much slower than the normal heart rate and the contraction of the heart chambers are not coordinated with each other. Because of this lack of coordination, the heart is in serious jeopardy of sudden cardiac arrest and even death.

Most third-degree AV block life insurance cases will get moderately substandard rates

The only exception is if the Heart Block was due to medication toxicity, caused by something like digoxin. These extremely rare cases would be rated standard.

Unresolved third-degree Heart Block cases will usually be postponed until treatment.


Most of the time we will be rating based on the underlying condition, not the block itself.  So you really need to read our articles on life insurance with a pacemaker, life insurance with coronary artery disease, life insurance after a heart attack, and life insurance with cardiomyopathy.

More than likely, you will have a condition that will impact your life insurance rates more than the Atrioventricular Block.

If you do have a congenital Heart Block with no other heart conditions, expect mild substandard rates.

How do you get the best rates on life insurance with a Heart Block?

First, live a healthy lifestyle.  Eat properly, skip the sugar and watch your carbs.  Get up and move around! Little steps make a big difference in your health.

Next, do you have an exercise (or treadmill) stress test in your cardiology workup?  No? Request one.

A recent exercise stress test with good results can lower your life insurance rates 20 – 30%.

Most importantly, work with an underwriting expert like the ones at Heart Life Insurance.  We understand more about life insurance with an Atrioventricular Block than anyone else you’re going to speak to.

The advice is free.  We know the life insurance companies who will rate an AV block favorably.

We know where to take your case to get the best value.


It’s time to face facts. You are as young as you will ever be today, right now, right this very minute.

Life insurance will only be more expensive tomorrow, then more expensive the day after that.

If life insurance with an AV block has been on your mind, why wait any longer? Think about how good it will feel to put this behind you and cross it off your list. Let the underwriting experts at Heart Life Insurance give you a hand today, we are happy to help.