Confused

Hi everyone, and thank you all for your wonderful insight and support on this site. Truly a great group of members.
My confusion hopefully could be clarified. I was diagnosed at age 50 with LBB and HF with an EF of 20% on February 2014.
I have been also told three months later since the diagnosis that I had some blockage of my LDA(Left Descending Artery) but not requiring stents only OMT- Medications.

My most recent Echos placed my EF at 35% and 42% most recently. My EP feels we should do an MRI of the heart to see if there is tissue damage that can be reversed and possible placement of an ICD.

My confusion is knowing that their exists a Ventricular Dysynchrony( My QRS is 142ms) and LBB- why would he not opt for a CRT-D implant instead, especially with those other 2 factors I mentioned?. My Ventricular walls are within normal parameters and the heart is not enlarged.

I am extremely grateful and fortunate my symptoms are almost non existent. I did lose 30 pounds and weigh appropriately now for my height of 5"8" at 165 lbs. Diet changed to Mediterranean and only Organic fruits, vegetables, with no processed foods and low Sodium intake,

4 Comments

Hi nivia

by IAN MC - 2014-07-13 01:07:17

You seem to have a mix of cardiac conditions related to your heart failure and each one gives different levels of risk to your future health.

So should you have a CRT or an ICD or a combination of the two ?? I suspect that different cardiologists would arrive at different conclusions because the published data in support of one or the other is not clearcut.

What does your cardiologist say when you ask him the question " Why not a CRT-D " ? It is your body and your decision so make sure that you understand his logic before agreeing to anything.

Predicting future likely risk is really not an absolute science when it comes to heart disease !

Best of luck

Ian

Other options

by Terry - 2014-07-13 02:07:06

Another approach is to restore natural ventricular contraction, which in reports allows the heart to heal itself (see Q&A page of PaaemakerPatientAdvocacy). The literature suggests it works when a narrow QRS can be restored when your EP paces the heart at the His bundle location.

A doctor I know says, "As I always tell my patients, there is the artificial way of pacing the heart muscle and the God given way of pacing the heart- we are going to try to replicate Gods work!"

Terry

im confused . . .

by capecod - 2014-07-14 06:07:13

how did you go from an EF of 20 to 42 in a short period of time?

Thanks to all !!

by nivla50 - 2014-07-15 12:07:35

First I want to thank all of you, Ian, Terry and Capecod for replying to my question and dilemma.

Yes I will ask him based on the latest MADIT studies as well. Cab't wait to hear his line of reasoning.

The Pacing at the HIS Bundle is amazing Terry. Thanks for the information and I will follow up on the MOST study recent results and procedure. Thanks again.

My EF went up to 42 % miraculously I feel. The only changes were the complete diet change- lots of Almonds, nuts, vegetables and fruits and fish-Salmon and Tuna, Tilapia three times a week. No meat and limited Sodium of 1500 mg and no more then 48 fluid ounces a day. Plus the meds and a lot of praying still. The weight loss helped me immensely as well. It's confusing I know, thats why I guess my EP wants to do further testing to see what is happening...
Thanks again to all and Best of Luck!!!

You know you're wired when...

You play MP3 files on your pacer.

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