I am a 64 year old active female. I have been diagnosed "left bundle branch block appears fixed now without rate related aberrancy, an exaggerated heart rate response to activity. I get very fatigued, short of breath and heart palpitations. This is affecting my activities, (play golf only 9 holes not 18, cannot ride horses without discomfort any of the things that have always made me an active person. I still do as much as I can but it is restricted. I have had all sorts of tests and most things are normal with no more blockages. (I do have 2 stents) My doctors suggests a pace maker but can only give me a 50-50 chance of it correcting my problem. I am 5'2" and weigh 122lbs. I am concerned to have something in my body that may not help. What is your suggestion
Fortunately, it is quite uncommon for stable LBBB to progress to complete heart block. Thus, despite the fact that BBB is a common finding on routine ECGs, it is an uncommon reason for implanting pacemakers.
There are a few conditions in which people with bundle branch block require pacemakers:
1) When “conduction system disease” is bilateral, and is associated with a heart attack.
2) When bundle branch block is associated with syncope (loss of consciousness):When a person with bundle branch block experiences syncope, in general an electrophysiology study should be considered to test for impending complete heart block. A permanent pacemaker eliminates the problem.
3) In certain people with dilated cardiomyopathy:In patients who have dilated cardiomyopathy and either complete or incomplete bundle branch block, a new form of pacing – called cardiac resynchronization pacing or CRT – has now been shown to improve symptoms and to prolong life. CRT should now be strongly considered in any patient with heart failure and bundle branch block. Click here to read more about CRT.
A bundle branch block causes the ventricles to beat sequentially (one after another) instead of simultaneously. This discoordination of the normal pattern of ventricular contraction diminishes the efficiency of the heart beat. In a person with a normal heart, the loss of efficiency is inconsequential. But in a person with dilated cardiomyopathy this loss of efficiency can be critical, and can contribute greatly to symptoms of heart failure. Resynchronization pacing restores much of this efficiency by pacing both the right and left ventricles simultaneously. In patients who have heart failure from dilated cardiomyopathy and bundle branch block, resynchronization pacing has become an important component to therapy.
I can understand your dilema with given a 50/50 chance at a pacemaker helping your symptoms. I was given the same odds, for a diefferent problem, and told that once it's there it's there to stay. I'm still sitting on the fence and haven't gone that route yet. I wish the answer you're looking for was easier to give.
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