Hi, I’m not a dr or specialist but I did see something called “his bundle pacing” and as suggested I would talk to your dr to find out exactly what this procedure is called. My niece had a bundle pack and EF rate of 15 and had to get a defibrillator and meds to help her cause of other issues, and she has what’s called a bundle pack. With your “twist” it made me think it might be similar to her situation. Please, I suggest you check further to see what this is called so you can get a better understanding what your dr. Is talking about. So much info out there it can get confusing. I pray you find answers and wish you the best. I have heart failure and had an EF rate of 30 which improved for now.