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Skipped heartbeats with bundle branch block
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Skipped heartbeats with bundle branch block

Hey everyone ...

So I went to my cardiologist this week to discuss a recent increase in the frequency of my skipped heartbeats. Usually I have 3-5 per day at most, but for a week or so in December, there were periods of time in which they would occur several times a minute. My cardiologist told me that on the last EKG I had done, he had detected a left bundle branch block, a sort of obstruction in the electrical pathways of my heart that could be causing the skipped beats. He wants to do a Holter monitor test and then maybe a cardiac MRI in order to determine how the blockage is affecting my heartbeat. I do the Holter test next week, and he advised me not to worry about it until then. Fat chance of that! Although I always struggled to believe that all of my heart problems were due to anxiety, which is the only diagnosis I received until now, it was reassuring to know that there was nothing physically the matter. Now that the situation has changed, my arrhythmia seems a thousand times scarier. Last night my skipped beats returned with a vengeance while I was lying in bed trying to fall asleep. My heart was going crazy, and with every abnormal beat, I was certain that the branch block was going to cause it to stop. I didn't get to talk to my cardiologist about the issue in very much depth, as he told me he didn't have much to say before the Holter monitor test. For that reason, I thought I'd ask on here if anyone has bundle branch block, and what the outlook is for this condition. Specifically, are skipped heartbeats more dangerous with a bundle branch block? I've only felt one skipped beat so far today, but I'm scared to do too much in case they come back ...
5 Comments Post a Comment
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1124887_tn?1313758491
Hey,

It's not completely clear to me what is going on here. I had to do some heavy arguing with myself here, on whether I should answer your post or not. I will give it a try, but please don't put too much weight in my reply.

If you had a persistent LBBB (in other words, sinus rhythm with LBBB), there is usually a reason for it. All recently developed bundle branch blocks (left or right) should be carefully examined, but a left BBB are more often (though not necessarily) an indicator of heart disease than a right BBB.

If you, on the other hand, had normal sinus rhythm with premature beats with a LBBB waveform, it's something completely different (and normal). Such beats can be PVCs that origin from the right ventricle, or PACs which are conducted with so-called aberrancy, because one of the bundles are still not able to conduct an impulse. Such PACs are often misinterpreted as PVCs.

Skipped beats (in this setting PVCs) aren't more dangerous if you have LBBB alone, if PVCs are dangerous or not depends on the underlying condition, but if you have a cardiac condition also causing LBBB, risk assessment should be done in light of that condition.

LBBB (I'm talking about the permanent condition, not that a premature beat now and then is conducted with LBBB) can happen for a variety of reasons. Some people are born with it, but if it suddenly happens, there is usually a reason for it. But most reasons can't apply to young females, so it all sounds a bit strange.

Common reasons:
Left ventricular hypertrophy, usually caused by long-standing hypertension. Extremely unlikely. Some people are born with a genetic condition which is thickening the ventricle, but I assume you've already had an echo done?

Heart attacks. I've never heard of them happening in young females.

Dilated cardiomyopathy: Can happen for a variety of reasons, substance or alcohol abuse, diabetes, heart infections or long-standing tachycardia. Don't freak out about the last part here, it usually happens when someone has a persistent heart rate >130 or so. Heart infections are diagnosed with cardiac MRI. Did you have an infection recently? If so, which one?

Stress cardiomyopathy. Extremely uncommon. Usually happens with phaeocromocytoma.

If you do have LBBB now, and are about to take a cardiac MRI, I assume your cardiologist wants to check if you do/did have an inflammation in your heart.

LBBB itself is just an EKG finding. It doesn't affect life quality, and the prognosis depends on the cause. In itself, it's not dangerous, but a young female suddenly developing LBBB warrants a lot of tests. It rarely happens without a reason, but the reason is often treatable.

If I remember correctly, you've had skipped beats for a long time, even without LBBB. They don't necessarily have anything to do with each other.

I'm so sorry this happened to you. Please keep us updated.

(and again, if you only had LBBB on your premature complexes, it's completely normal).
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1423357_tn?1414258965
I agree with Andre.  I don't know a great deal about BBB.  But you're a young woman, and you shouldn't have any of the conditions that cause BBB.

I respectfully submit that you are going to the wrong doctor.  As I've suggested before, the doctor you really need to go to has a PhD after his name. Please be well.
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1298588_tn?1330322581
Just an update, everyone: I'm completely healthy! After detecting the bundle branch block and completely freaking me out, my cardiologist had me wear a Holter monitor for 24 hours to assess the effect of the branch block on my heart. When he found no evidence of arrythmia of any kind, he booked me an ultrasound and a blood test to dig deeper into the nature of my condition, and again found absolutely nothing wrong with me. At this point, he determined that as there was no evidence of an underlying cause for my bundle branch block, it was either a temporary condition caused by an infection of some kind, or even a glitch on the ECG. He even went so far as to consider the possibility that the ECG he examined was actually somebody else's that was mistakenly labelled as mine, so great was the contrast between the bundle branch block and my otherwise perfect test results.

In short, I have been given a clean bill of health. I have been feeling really well lately anyway, with only one minor episode of tachycardia in several months, and skipped beats few and far between. It seems as if I can finally push my health concerns out of the front row centre of my mind!

Thank you all again for your amazing advice and support, and I wish you the best of health as well!! :)
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1124887_tn?1313758491
Great to hear! Keep going strong and let us know if you have other questions or worries :)
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1807132_tn?1318747197
That is indeed good news.  Hope you just keep feeling better and better.  :)
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