LBBB, Sinus Arrythmias, & possibility of needing a Pacemaker

Posted By Barbara B. on March 01, 1999 at 16:34:12:







I have posted a question before in this forum and have greatly appreciated the helpful information.  Thank you.  Now for my new question.  First let me give some background info.  I am 33 years old, and have been seeing a cardiologist since 12-28-98 due to questionable palpitations, dizziness, a complete LBBB and a fairly new heart murmur.  Stress test showed a complete LBBB, and an echo showed mitral valve regurgitation, but minimal at this point.  My cardiologist today told me that my 30-day continuous loop event recorder showed abnormal heart rhythms.  He said I have sinus arrythmias, and that my heart is definitely slowing down during many intervals on the strips of EKG that my heart monitor revealed when I placed my recordings.  After he consulted with the 2 electrophysiologists in his office, he said that they all agreed that although my heart is slowing down, and I have episodes of dizziness/lightheadedness, plus abnormal rhythm patterns, they are not quite to the point where he can put a pacemaker in me.  I told him that 2 weeks ago I was dizzy/lightheaded for about 3 1/2 hours, and had a pulse rate of 48-50 bpm.  He said that I should go to the ER the next time this occurs because it may be the info he needs to be able to put a pacemaker in place.  He also told me that just because I was not able to record a significantly dangerous arrythmia does not mean that I am not experiencing them, and he is ordering another 30-day event recorder to try to "capture" a significant episode.  He told me basically that until my heart gets bad enough that I start passing out, they cannot do anything for me due to the reason that my arrythmias are happening, which he is attributing to my LBBB.  He also told me that my particular unpleasant episodes of arrythmias cannot be treated with meds, but would only be stopped by a pacemaker, because my heart is actually slowing way down, not speeding up.  I guess I have the following questions:
1.  Should I get a second opinion?
2.  At the age of 33 and in otherwise good health, is it common to have a LBBB with these other symptoms?
3.  Because I am afraid to start having "passing out" episodes while driving or in other potentially dangerous situations, isn't there any other way to determine my need of a pacemaker before I have to start passing out?
4.  I understand my doctor's desire to wait until absolutely necessary to perform either a heart cath. or put in a pacemaker, especially given my age, but I know 2 people between the ages of 60 and 70 who also have these spells of unpleasant feeling irregular heart rhythms who are on oral medication and say that once they started taking the medicine, they didn't feel the unpleasant sensations anymore.  Why can't I have medication like them?  Does my complete LBBB make everything that different?  
Thank you so very much for your help and information.  I will be seeing my cardiologist again in 3 months, but knowing all I can about my condition makes me feel better in my head, if not in my "heart".  Thank you.