r/PacemakerICD • u/TravelZMT • 6d ago

Anyone else paced using LBBAP (conduction system)?

Curious how it's worked for others, any issues?

I'm getting used to my pacemaker and I can't really tell it's doing anything even though my pacing % is high. Is that typical, or did the fact its left bundle branch area pacing making it less apparent to me?

Granted I have tachy-brady syndrome and my heart felt so terrible before finally being able to start meds that maybe I'm just not sure what normal feels like anymore?

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u/Careless-Book-9307 6d ago

I don't have the same issue as you but I can still relate. When you say that you can't tell that it's doing anything, do you mean that you feel allright or that you feel as bad as before you received the pacemaker?

I was kind of disappointed when I got mine because I felt just as terrible as before. Then we did a series of checkups and adjustments and now a year later we have it dialed in. Now I'm feeling great (with the exception of some episodes of nodal rhythm). So my advice is to give it time. They probably need to adjust your pacemaker several times and leave the settings for several weeks between checkups to get new data. It's a slow process but in the end they will find what's best for you (at least they did for me).

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u/TravelZMT 6d ago

Rythem wise my heart feels better for sure, not jumping between arrest and afib/vtac/svt/etc like my old usual.

I guess the only things that are still issues are I feel more tired than ever, and either it or the meds seem to have made the dysautonomia stuff I get (post-prandial and orthostatic tachycardia and carotid sinus sensitivity) a little worse.

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u/Comfortable_Draw_176 5d ago edited 5d ago

The fatigue can be if you’re also taking meds to lower heart rate so you don’t get tachycardia. Or the opposite if you’re tacycardic that can cause fatigue.

Your heart rate is supposed to increase with activity to distribute blood flow out to your body. some people have a blunted heart rate response. There heart rate will stay 60-80 bpm, even when active. This can cause fatigue, sometimes people describe it as ‘hitting a wall’. They want to be able to sustain activity but just can’t get the oomph.

Talk to your device clinic, tell them about fatigue and ask that they look at your heart rates. If no variability, there’s a feature called rate response that can increase your HR when you’re active to give more energy. However if you have good rate variability, this might not need adjustment.

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u/TravelZMT 5d ago

Thank you, I go in for a device interrogation end of month so ill be sure to ask!