RBBB

[PikaPika88]

When I was 15 yrs old and diagnosed with WPW : PAT & RBBB.  Last September I went to ER for chest tightness and found the ER wrote (old)LBBB.  My cardiologist explainted to me I didn't have LBBB when my pacemaker is pacing the heart (2 leads St Jude's Pacemaker).  They didn't mention about my RBBB anymore.  A-Fib found when I went in for my regular pacemaker check up in this year February.  The following are my questions:

1.  Could this new LBBB form when my one lead pacemaker failed (lead leaking) in 1995 which I ended up with a complete heart block?

2.  Is RBBB or LBBB staying on all the time or it just on and off from time to time?  Any chance can unblock it by medication or surgery?  How can I get rid (cure) of it.  

3.  I can't understand about: I didn't have LBBB when my pacemaker is pacing.  What happen if the pacemaker is not pacing?  

4.  My doctor said the LBBB showed at the ECG whole lots is "WPW Sydrome".  Is that all the WPW Sydrome will show LBBB on their ECG?  Why mine 15 yrs old ECG only showed RBBB not LBBB?

5.  My chest has tightness since I took the Verapamil 160 SR.  Now had stopped for about 3 weeks. The tightness still there everyday.  How long to take the Verapamil wore off?  I'm only taking Flecainide and Somac at the moment.  Is Flecainide or Somac causing chest tightness as well?

6.  My heart is still very naughty and not behave. Looks like the big (strong) beats are chasing the small (light) beats.  Do you know where they from? and what cause these?

Thank you for looking at and answering my post.

Pika.

[PikaPika88]

My first pacemaker "PASAR" was implanted before the ablation.  They told me the pacemaker can stop the palpitation so I don't have to take medication.  It worked. Only for 3 days. After 3 years, I'd the ablation.  Woke up, the pulse dropped to 40 so they changed another type of pacemaker for me for insurance.  That's all happened in 1982 and 1985. Hope your verapamil can control your palpitations successful.  Let me know if you have more questions.  Pika.

[compassion]

I am 24 years old and I noticed my first palpitation when I was in the fourth grade and my first run of PSVT when I was a young teenager. I am on verapamil 240mg. They are not for sure if I have WPW, but they know I have a re-entry mechanism and they are considering ablation. My concern after reading your post is will I eventually have to have a pacemaker? Why did you have to have a pacemaker, I was told the ablation could take care of my problem. I'm so ready to give up on my heart.

[PikaPika88]

How you feel now?  Until now, I'm still don't know how is PVC, PAC looks like.  Do I have one before or not?  My cardio never tell me.  Do you need to take any medication for your palpitation?  Do you know this ablation is successful or not?  I'm a mom of two.  At the moment, I've a bit of trouble in my heart (naughty heart not behave).  Keep me in post and let me know how you go.  Take care.  Pika.

[Witchy2u2]

My EKG also shows an incomplete RBBB.  I have suffered with tachycardia for about 20 years.  For me, being a single parent and working a few jobs, I was given the diagnosis of anxiety.  Recently, I changed physicians, she is great and took me seriously and did an EKG which showed WPW.  I had an ablation a year ago and they were not able to produce the arrythmia.  Two months ago, I began having them to the point that I nearly passed out.  Once again I went in for an EP study.  Not my favorite test at all.  They were once again unable to trigger the WPW which apparently is on the left lateral wall of the heart and riskier from what I understand.  They did however induce AVNRT which from what I understand kicked in at over 250 BPM.  They did do ablation.  It has been less than a week for me and a thousand questions for the doctors about the RBBB and they keep saying it is because of the electical conduction of my heart and not to worry about it.  I am exhausted from the ablation and am hoping that it gets better because I seem to feel even more PVC's now and am very fatigued.  I can relate to your questions and wish you luck.

[PikaPika88]

Thanks Doctor.  I've got some of the answers that I want.  Although not all, at least I understand the condition already.
Appreciate for your help.  Thanks again.  Pika.

[CCF-M.D.-MJM]

Hi Pika,

1. Could this new LBBB form when my one lead pacemaker failed (lead leaking) in 1995 which I ended up with a complete heart block?

If you have a bipolar pacemaker, they may have missed the pacemaker spikes.  This is very common.  If you have complete heart block, I bet this was an unnoticed spiker spike.

2. Is RBBB or LBBB staying on all the time or it just on and off from time to time? Any chance can unblock it by medication or surgery? How can I get rid (cure) of it.

RBBB and LBBB are usually for keeps.  They are symptomatically treated with pacemakers when necessary.

3. I can't understand about: I didn't have LBBB when my pacemaker is pacing. What happen if the pacemaker is not pacing?

If you have complete heart block, you are probably pacing most of the time.  Pacing the right ventricle causes a LBBB on the EKG.  It is not pacing, the complex will depend on your underlying rhythm.

4. My doctor said the LBBB showed at the ECG whole lots is "WPW Sydrome". Is that all the WPW Sydrome will show LBBB on their ECG? Why mine 15 yrs old ECG only showed RBBB not LBBB?

I am not understanding the question very well, and even if I did, the QRS morphology in WPW is complex and something most cardiologist struggle to remember.  I would not be able to explain it in ths forum.

5. My chest has tightness since I took the Verapamil 160 SR. Now had stopped for about 3 weeks. The tightness still there everyday. How long to take the Verapamil wore off? I'm only taking Flecainide and Somac at the moment. Is Flecainide or Somac causing chest tightness as well?

None of these medications cause chest tightness.

6. My heart is still very naughty and not behave. Looks like the big (strong) beats are chasing the small (light) beats. Do you know where they from? and what cause these?

I cannot answer that questions without seeing the ekg.

I hope I was able to explain some of your questions above.

Good luck!