Left Bundle Branch Conduction Area Pacing

I'm 79. I've had an LBB for decades. Never caused any serious issues. About this time last year, I noticed a sharp drop in my endurance. Even a short walk would make me very fatigued. That lead to lots of tests and an Advent Health cardiologist who changed my BP med to Nebivolol from Metoprolol. In Nov 2025, an EKG showed a possible heart block. In Jan 2026 I had a stress test which showed a heart block. The cardiologist said these were "test errors".

On June 14, 2026 I woke up with a heart rate of 30. Possibly caused by the BP meds. Nevertheless, I went from the Advent Health ER by helicopter to their main hospital in Orlando for a temporary pacemaker installed that afternoon. Two days later, a leadless Medtronic Micra AV2 was implanted via a vein in my groin. It is the size of a large vitamin pill and goes inside the heart. It guarantees a minimum heart rate and synchronizes upper and lower chambers.

The pacemaker worked fine, but my BP remained very low no matter what I did. That lead to another trip via helicopter three weeks later when it was discovered (by my gasping for air) that I had large pulmonary blood clots blocking blood flow - which were also indicated by the stress test but never mentioned by the Advent Health cardiologist.

My advice: Read the test reports yourself, learn what everything means, and take nothing for granted. My biggest mistake was trusting the cardiologist (who never showed up in either of my two trips to the Advent Health ICU).

@mmm123 Welcome to Connect! I'm glad you joined us and are looking for others to share their experiences regarding LBB Area Pacing. I am sorry that you have to deal with this and at the same time I am admiring your desire to reach out and learn more. I am also glad that you have an appointment with an electrophysiologist in a couple of weeks. I have no experience with LBB (I had to look up to learn LBB meant left bundle branch), and I just read the experiences of @jimgrupe.

I definitely agree with his suggestion to (learn to) read the tests reports yourself. We learn new vocabulary words. We also need to know the meaning of all those medical acronyms. We encourage people to be their own loud-but-polite advocates (squeaky wheels get the grease) and to learn all they can about their particular medical situation. I just researched "Mayo clinic Left Bundle Branch Conduction Area Pacing" and several items appeared. Because I have no experience with LBB Area Pacing, I cannot wisely choose links for you to read if you choose to. May I suggest putting the quoted part in your browser and reading items from reliable sources (Mayo, NIH) that you think will enhance your knowledge. That may generate questions for your upcoming electrophysiologist visit.

I acquired Buddy, my ICD at age 76 in 2022 because my lucky heart developed electrical issues (arrythmias) starting a couple of weeks after a septal myectomy at Mayo, not uncommon. The defibrillator is my 24/7 personal EMT, I have never had a shock, but I am paced. How long have you had this heart issue? How did you know that you needed intervention for it? Where do you receive your care?

I do all the research for my husband who is the patient. He was probably in his forties when his cardiologist at the time diagnosed him with LBBB (left bundle branch block). If I remember correctly, I think he said that my husband was born with it. His ejection fraction was normal until he began treatment for Multiple Myeloma that lowered it some. Then he had persistent a-fib that lowered his EF waiting to get a Pulse Field Ablation which has been successful. His EF has not recovered hence the need for LBBAP or CRT and perhaps a defibrillator. He has an implanted Medtronic Loop recorder that has been monitored by his electrophysiologist. His doctor performs cardiac procedures at Ochsner in New Orleans and has an excellent reputation for his knowledge, skill, and attention to detail. He was recommended by my husband’s oncologist.

@mmm123 Thank you for sharing, I learned much from this post. Your husband is working on caring for several serious medical issues, and you are too, as his spouse and advocate. Your explanation emphasizes how all the workings in our bodies are so dependent on each doing its job well. Wishing him a productive visit with his electrophysiologist.

Times have changed! We have to take charge of our care. I think of myself as the CEO in charge of my care with a diverse team supporting me. One such team member is not a person. It's ChatGPT. I upload test results and reports. Chat translates them into language that I can understand and that goes beyond what any doctor has told me. However, I don't use Chat for anything more. By the way, I too have an AV 2:1 heart block and LBBB. My pacemaker (Apr 2025) basically gave me my life back. Best wishes, Ted

Thank you Ted. We put information in to Chat GPT and I’ve also used COPilot to compare the two and yes, they are very helpful in their explanations and providing questions to ask our doctors. Im happy to hear the CRT has been helpful to you.

@mmm123 and @ted3, search tools like AI agents (ChatGPT, Copilot, Claude, etc.) can be very helpful and a great starting point when researching about your health.

When uploading medical records, lab tests, reports, and personal identifying information, protect your privacy. Don't share personal information, like your full name, date of birth, address, medical records or insurance details. Even health details should be shared cautiously, especially on public or free platforms.

Always verify. AI agents can sound confident even when they're wrong.

In these articles from Mayo Clinic, learn more about using AI tools safely for your health.
- Can you trust AI for health advice? https://connect.mayoclinic.org/blog/about-connect/newsfeed-post/can-you-trust-ai-for-health-advice/
- What is Generative AI? What does this mean on Mayo Clinic Connect? https://connect.mayoclinic.org/blog/about-connect/newsfeed-post/what-is-generative-ai-artificial-intelligence-what-does-this-mean-on-mayo-clinic-connect/

Defining new terms and helping to prepare for an appointment with your doctor are great ways to use AI. There's so much to learn and an AI bot can evaluate a lot of information fast and put it into plain language. We're all going to get better at learning how to phrase questions for AI too. 🙂

@mmm123 and @ted3 How has Left Bundle Branch (LBB) affected your lives?

For those following this discussion, here is Mayo's easy-to-understand explanation of LBB https://www.mayoclinic.org/diseases-conditions/bundle-branch-block/symptoms-causes/syc-20370514.

How did your doctors make your LBB diagnosis?

@mmm123 "Has anyone had experience or knowledge with LBBAreaPacing? "

Yes, I had a dual chamber pacemaker implanted in January 2025 for Mobitz II 2:1 AV block with one lead in the atrium and the second lead in the LBB Branch area. LBBAP This is a newer pacing location than the RVP (left ventricular pacing. )
From my understanding, this location lowers the heart failure risk over RVP .

Left bundle branch (LBB) pacing became widespread starting around 2022.
My Ejection faction has been in the normal range, so my situation is not the same.
If I understand you correctly, you have two choices, two lead pacemaker with RVP and defibrillator or two chamber with LBBAP??