freaking out here

I am 64 with LBBB, Dilated cardio myopathy, and A-fib, the latter diagnosed this past June, the LBBB and cardio myopathy diagnosed in 2008.  After years of an Echo and Nuclear Stress tests registering an EF of 38, with the A-fib addition Cardio Doc recommended an MRI.  MRI came back at 33.  I know 35 is the threshold, but do I really need a "three-lead CRT" device for Pace, Defib and sync right now?  Doc recommended and tried to schedule ASAP.  After reading some of the comments and questions about quality of life, sleeping on left side, and playing golf (100+ times/year), I am on the fence about delaying it until I have some symptoms, any symptoms, other than occasionally feeling the irregular heartbeat when laying in bed.  I'm trying to get as much information as possible, including a second opinion at U of PA, for which those Docs said my initial diagnosis and recommendations are what they would reco.  Help?  Thank you all for your postings and sharing. 


5 Comments

CRT-D

by The real Patch - 2017-10-18 16:40:34

are you saying you don't currently have a CRT-P (pacemaker) with having LBBB?

I'm getting fuzzy on some of this stuff, but I believe 30%EF was the threshold for an ICD (Defibrillator). You may want to double check that because insurance won't pay for an ICD unless you meet all the criteria. You do need understand you are at increased risk of SCA with a low EF like that and the defibrillator fiunction is a pocket pal to reduce the risk. think about it, you are having the golf round of your life and on the 18th tee your heart stops...with the defib that's not a concern. Just shake off the Jesus Jolt and finish the round. Then again if you play like me, ending the round prematurely may be a blessing.

It's unclear if you have some device now, but if you do, you won't really know the difference from the CRT-D. Still, whether you have a device or not, it's not a big deal.

 

nothing foreign inside of my chest yet

by R33 - 2017-10-18 16:57:13

Thank you for your response.  No, I don't have any device in me yet.  I'm in the process of sorting out this life altering diagnosis that I need an implanted device at all.   I was told eyars ago that when my EF goes below 30 I would need a defib, but now was told to me I need a three-lead device, and my EF is 33.  :( 

Make sure doc knows your concerns and get it done

by LondonAndy - 2017-10-18 21:39:48

You could get a second opinion as to whether you need the device now or not, but if that confirms what your current one is saying then make sure that they know your concerns.  I don't know about CRT devices, I have a dual chamber pacemaker, but I assume that they too can be inserted in different places to avoid sporting restrictions. Though there can be a downside too, such as how easy it will be to replace it when the battery starts to go down.

My pacemaker is inserted pre-pectoral, and it took a while (almost a year) but I can sleep on my left side with no problem.  However, ironically I now sleep on the other side of the bed and mostly sleep on my right side! 

There are also now wireless devices that might be suitable, and help avoid affecting your golf swing.

Thank you

by R33 - 2017-10-18 21:57:32

Thanks, Andy.  

CRT D

by Renny - 2017-12-29 01:28:51

We're just about a match.  I’m 63 with dilated cardiomyopathy and LBBB.  as well as Type 2duabetes and chronic kidney disease.  But I had no idea of my heart issue until August 2017.  I had a tachycardia and called an ambulance (in Australia).  They found the LBBB.  my only symptoms were a gradual decrease in exercise tolerance.  I had no Idea.  On investigation my ef was 30, and everyone was recommending CRT-d.  I was so frightened I didn’t argue.  Fortunately here the cost isn’t an issue.  I had my device implanted on 17 November.  Some issues but nearly five weeks in i can notice a difference.  More energy. Less fatigue.  It is scary but I think I'm still young and LBBB means I’d had one heart attack without knowing it.  I just wasn’t prepared to risk a-fib and possible death.  Not sure this helps as I’m early into the process, but docs say I can get back to swimming and kayaking in a few months.  And yes m fairly resilient physically.  The m slowly gained ng confidence in the support available to me.  Good luck.

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