It sounds like there's a concern about whether a Bundle Branch Block (BBB) progressing to complete heart block in nonobstructive HCM (nHCM) could have been missed, and whether a pacemaker is the right next step. That's a really important question worth unpacking.
In nHCM, the heart muscle thickens without directly blocking Show Full Answer
It sounds like there's a concern about whether a Bundle Branch Block (BBB) progressing to complete heart block in nonobstructive HCM (nHCM) could have been missed, and whether a pacemaker is the right next step. That's a really important question worth unpacking.
In nHCM, the heart muscle thickens without directly blocking blood flow, but it can still cause serious electrical problems. A Bundle Branch Block means the electrical signals in the heart are delayed or blocked, and if this progresses to complete heart block, the heart's upper and lower chambers stop communicating properly — which can be dangerous. When nHCM is missed or diagnosed late, electrical complications like these can go unmanaged for longer, which may increase risk. Here's what's generally relevant in this situation:
- Arrhythmias are a known complication of HCM, and electrical conduction issues like BBB fall into this category
- An electrophysiologist (a heart rhythm specialist) would be the key doctor to see for evaluating complete heart block
- A pacemaker helps manage slow or blocked heart rhythms by sending electrical signals to keep the heart beating properly
- An ICD (implantable cardioverter-defibrillator) may also be considered if there's risk of sudden cardiac arrest alongside the conduction issue
The right device depends on the specific rhythm problem, overall heart function, and individual risk factors. A cardiologist or electrophysiologist can review test results like an ECG, cardiac MRI, or Holter monitor to guide that decision. If there's a feeling that the nHCM diagnosis was delayed, it's completely reasonable to seek a second opinion from an HCM specialist. HCM centers of excellence exist specifically for complex cases like this, and they can reassess the full picture — including whether earlier intervention could have changed things and what the best path forward looks like now.
June 18
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