LBBB

I am a very healthy physically fit 35 year old woman.  I have never been ill and I take no medicine.  I work out nearly every day, to include running. I just found I have a LBBB six months ago, I was symptomatic at the time.  I have had an echo, CT, MRI and two stress tests, I have worn a holter monitor and an event monitor.  All show I indeed have a LBBB but no structural abnormalities to be found.  MY EF is at the low end of normal range.  I am very frightened, despite my cardiologists attempt to reassure me.  Is this type of condition common?  Can it be exacerbated by external factors, such as stress, anxiety, caffeine?  I am fearful I am going to suddenly die, and have become very very anxious.  Please help with any input you may have.  I again, am very scared.

[Michael J. McWilliams, M.D.]

I understand that you are afraid.  You are young and do not want any health problems.  There are questions that can be answer and ones that cannot be answered.  Sometimes is important to know what does not have an answer so you don't keep asking the same question when no one can answer it.

The condition is not common for someone your age with no medical problems but it does happen.  There is often no good explanation for why it happens.  You should be reassured that your heart studies are all normal.

It is unlikely that you will develop heart problems because of this but people with a left bundle branch block have a higher frequency of developing a cardiomyopathy.  This is probably not because the left bundle causes it but because it reflects an early sign of intrinsic heart disease and this is an early manifestation.  You probably do not have this condition.  I would advise a person in similar circumstances to live your life as normal but I would see you back yearly for a few  years to make sure that your heart function remains stable.  I know this is not what you want to hear but this is how I would handle it.  I have never read any formal recommendations on follow up for LBBB in young healthy people.

The take home message is:
You are at low risk for sudden death based on left bundle and normal heart function
There is a possiblility of developing heart problems but there is no evidence of it yet.  Don't worry about what you don't have but I would recommend appropriate screening tests, possibly yearly especially early on-- this is subjective.

I hope this helps.

[tsco]

Hey,
I am 45 male and in good shape except for my heart rythm stuff.  I started with fast rythms, have had a few ablations for that and then several years ago I started having the LBBB.  MY cardiologist always says its common and don't worry about it as long as the rest of your heart is normal. The thing he always ignored at first and acted surprised by was I could feel when it happened and I had symptoms.  He claims that's unusual.  MY LBBB happens when my heart rate gets around 115 to 120 BPM.  Then typically I get a chest pain and can feel the out of rythmness. IT stinks because I can't hardly excercise or do the outdoor stuff I love. I take a beta blocker to slow my pulse and this helps.  Mine is obviously rate induced.  My docs say people with LBBB can not feel it which I have told them is bull.  I would like to talk to you more about what symptoms you feel and the triggers....and yes stress anxiety and caffiene can play a big part as a trigger.

[linier]

I just had an ablation for frequent PVC's and what they thought was VTach.  Turns out I have exercise induced LBBB.  I am only 37.  And I can tell you for sure I know when I go into it and out of it.  Around 155 beats, I feel a weird feeling in  my throat and my HR watch goes crazy.  I stay in it for 2-4 minutes then the feeling in my throat goes away when I'm out of it. So tell your doc he can't speak for us!

[bobad]

It's in everyone's best interest if you can not feel that which will not hurt you, or nothing can be done about.  The Doc's are trying to help us when they tell us that most people can't even feel LBBB, PVC', etc.

That said, those of us who can feel these conditions need to be told they are not crazy or it's all in our heads. Not only can I feel PVC's, but I can easily feel the qualitative difference in PVC's while on beta blockers and not on beta blockers. I can feel the leads to my pacemaker rubbing against my heart valves, and I can feel the leads stuck in my heart. I can easily feel the difference between the paced beats and normal beats. As long as my doc acknowledges it and tries to help, I'm OK. If he tries to deny that I can feel any of it, I'm looking for another Doc.

[PikaPika88]

Originally I have RBBB when I was 15.  I also have wpw.  When I was 24, dr put a pacemaker in.  I don't know when it started but I noticed when I was 47 years old.  The ECG in the ER showed LBBB.  (No RBBB because it was paced at the RA and RV.)  Dr MJM explained that when the pacemaker is pacing at the right ventricle, it shows LBBB on the ECG.  I wonder that he answered in this post: "people with a left bundle branch block have a higher frequency of developing a cardiomyopathy.  This is probably not because the left bundle causes it but because it reflects an early sign of intrinsic heart disease and this is an early manifestation."  Would this apply to me soon or later?  Could I ask my EP turn off the pacemaker a little while to see the LBBB still there?  Does it work out like that?  He didn't want to turn it off.  When he put the pacer in, my heart was completely normal and healthy.  It sometimes naughty and beated too fast.  

[Kay7895]

A related discussion, LBBB was started.