Left Bundle Branch Block (LBBB) life expectancy?

Posted by dizzyprizzy @dizzyprizzy, May 18 11:17am

What is the life expectancy of a female aged 64 with LBBB, 35% EF and idiopathic cardiomyopathy, which means no cause can be found for the heart failure? Have there been any studies of people over 60 who are otherwise healthy who get LBBB. Mine was discovered on an EKG required for out patient surgical procedure. How many years can we expect to live on average?

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@davidok

I have a LBBB. I'm 58 now and have been on meds (also Entresto and Coreg) for about 8 years due to low Ejection Fraction (EF). I've been at 25-30 Ejection Fraction for the past few years. My cardiologist has been pushing for a couple years now to get me into a pacemaker because of the EF. I understand that I need a pacemaker but am active and don't experience any symptoms while exercising, or really any time. I am worried about being limited in what I can do (my EP said basically no upper body weightlifting or anything that repetitively works the shoulder joint, like swimming, because it could loosen and break the wires). I don't want to not get a pacemaker and damage my heart further, but I'm nervous about the life change after getting a pacemaker. Your story gives me optimism.

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Davidok,

Do the research on the QRT. They only last a few years and are not like pacemakers for AFIB. https://pubmed.ncbi.nlm.nih.gov/26740015/ The National Institute of Health has good information about His-Purkinje system where the LBBB originates from in the heart. The latest QRT (left ventricle pace maker) information is there but the reading is difficult. I had to use a medical dictionary.

I am no doctor but I would get a second opinion.

It appears to me that those QRT's are for people who have been rejected for a heart transplant and want 18 months to 3 years more to live. If you are doing well, wait. You can always do it later. With the QRT, when the leads come out of the heart, the heart muscle is damaged. The spot that the QRT shocker wire has to be implanted is like a the size of the head of a ten penny nail. If that breaks well??

Easy for me to say: My ejection fraction varies from 35 to 39. I like you have Idiopathic Myocardiopathy (heart failure with no known cause). LBBB is very rare without any underlying cause. Two cardiologists say I had a virus that caused this but the virus isn't the viruses they tested for in me. I decided against the catherization procedure at the EP doctor in July 2024 because I frankly don't know the risks of having those electrodes put into my heart muscle to do the testing for the exact locations of LBBB.

I am on Enalapril as I am allergic to the "inert" ingredients in beta blockers. If I could take beta blockers my EF would be higher. It is good you can use beta blockers successfully.

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@healthseeker77

Here is an article from the NIH about LBBB - it sounds like your life expectancy is similar to other people of your same age:

What is the life expectancy of someone with LBBB?
Patients with isolated LBBB and no associated structural heart disease, ventricular dysfunction, or CAD have 10-year mortality that is comparable to that of similar-aged individuals. In addition, these patients have a low rate of cardiomyopathy and heart failure hospitalizations.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114733/#:~

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Thanks for the information. I had a myocardial infarction August 17th and survived. I am waiting to find out what it did to my EF and so on. My cardiologist wouldn't talk to me after the ER visit. I have questions. The cardiologist had her nurse read aloud to me over the phone the cardiologists interpretation of the tests they did at ER. I can't get a new cardiologist to talk to me my only approved cardiologist care allowed by my insurance until 12-18-24.

Looking for a new cardiologist for the New Year when I will be on Medicare and have some choice.

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@jc76

@gloaming
Yes! When they use the term and diagnosis of heart failure the patient experiences extreme stress most of the time. The term is terrible. I like Reduced Heart Function and call is RHF. This more accurately describes the condition. Heart failure means heart has failed and it has NOT.

Come on caridologist think about mental and psychiatric aspects of diagnosis.

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I have had those same thoughts for a long time per the term "heart failure" -- appreciate the related comments here.

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Consult major teaching hospital, like PennMed in Philadelphia. 100 Md cardiologists? Worth the $600 flight. Do a deep dive. Rule out Lyme, fatty infiltration, etc.

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Parasites, bacterial growth on valve leaflets?

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Many causes must be investigated. Cannot post link
Here are some in ncib article
Structural heart disease: Coronary artery disease (CAD), hypertension, cardiomyopathies such as dilated, left ventricular noncompaction, stress, and hypertrophic cardiomyopathies, and aortic valve diseases like aortic stenosis and regurgitation
Degenerative changes: Age-related fibrosis, Lev disease, and Lenègre disease
Lev disease is a form of idiopathic, age-related progressive cardiac conduction disorder characterized by extensive calcification and fibrosis of the cardiac skeleton, including the aortic valve annulus, mitral valve annulus, and interventricular septum. This calcification can extend to involve the His bundle and the bundle branches, manifesting as bundle branch blocks, commonly LBBB, and varying degrees of atrioventricular block, which can progress to complete heart block. Lenègre disease involves age-related, progressive degeneration of the conduction fibers, leading to fibrosis and sclerosis. This degeneration typically affects the His bundle and its branches, leading to various conduction blocks, LBBB being the most common.
Infiltrative conditions: sarcoidosis or amyloidosis
Inflammatory cardiomyopathies: Infectious myocarditis or autoimmune disease
Iatrogenic: Following cardiac surgery involving the aortic valve or interventricular septum or after transcatheter aortic valve replacement (TAVR)
At least 30% to 50% of patients develop LBBB after TAVR, which independently predicts mortality in these patients.[5]
Electrolyte imbalance: Hyperkalemia
Medication: Anti-arrhythmic medications
Congenital structural heart disease
Idiopathic: Particularly in younger patients or individuals without significant cardiac risk factors

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Also hypokalemia and hypomagnesemia, inappropriate DOAC prescription, pericarditis from many causes, pulmonary hypertension,....the list is as sobering as it is long.

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@david472

Many causes must be investigated. Cannot post link
Here are some in ncib article
Structural heart disease: Coronary artery disease (CAD), hypertension, cardiomyopathies such as dilated, left ventricular noncompaction, stress, and hypertrophic cardiomyopathies, and aortic valve diseases like aortic stenosis and regurgitation
Degenerative changes: Age-related fibrosis, Lev disease, and Lenègre disease
Lev disease is a form of idiopathic, age-related progressive cardiac conduction disorder characterized by extensive calcification and fibrosis of the cardiac skeleton, including the aortic valve annulus, mitral valve annulus, and interventricular septum. This calcification can extend to involve the His bundle and the bundle branches, manifesting as bundle branch blocks, commonly LBBB, and varying degrees of atrioventricular block, which can progress to complete heart block. Lenègre disease involves age-related, progressive degeneration of the conduction fibers, leading to fibrosis and sclerosis. This degeneration typically affects the His bundle and its branches, leading to various conduction blocks, LBBB being the most common.
Infiltrative conditions: sarcoidosis or amyloidosis
Inflammatory cardiomyopathies: Infectious myocarditis or autoimmune disease
Iatrogenic: Following cardiac surgery involving the aortic valve or interventricular septum or after transcatheter aortic valve replacement (TAVR)
At least 30% to 50% of patients develop LBBB after TAVR, which independently predicts mortality in these patients.[5]
Electrolyte imbalance: Hyperkalemia
Medication: Anti-arrhythmic medications
Congenital structural heart disease
Idiopathic: Particularly in younger patients or individuals without significant cardiac risk factors

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Hello @david472, there are temporary holds on new members sharing links to help protect the community. Allow me to help share the link you were trying to include in your post:

"Left Bundle Branch Block" - https://www.ncbi.nlm.nih.gov/books/NBK482167/

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have had LBBB for at least 15 years that has not been associated with an etiology. For at least 5-7 years it was sometimes on the EKG and sometimes it was gone. After issues with Aflutter it become permanent. I have had a successful aflutter ablation 12 years ago but since then have developed Afib. The key to LBBB as I understand it Long Q issues and echo exam. Every 2 years I have an echo and my LBBB apparently is stable. As long as the time between heart beats is not affected causing symptoms then one does not need a pacemaker. Correct me if I missed anything.

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