Is anesthesia risky with a bifascicular bundle block?
Patient's Query
Hello doctor,
I am 60 years old. I have a BMI of 33. I have a bifascicular bundle block. I take Salbutamol and Fluticasone (Relvar) puffers for asthma, which is lifelong. I have seen my GP and my cardiologist and have been cleared for bariatric (gastric band) surgery next week, in order to expedite some weight loss, as my asthma has prevented me from much exercise. However, I am nervous about the anesthesia given my bundle block, and I am here seeking informed discussion and expert counsel.
I am here seeking a basic outline of what will be the anesthetist's approach, given the bifascicular block. I have a reasonable understanding of basic medical issues as found in peer-reviewed articles, which I have read via my university. But obviously, I lack the medical training to be able to figure out the anesthetic procedure and perioperative risk by myself. I am making this inquiry so that I might discuss this with my anesthetist in a more informed way before I meet him tomorrow.
Please guide.
Thank you.
Hello,
Welcome back to icliniq.com.
Bifasicular block is commonly RBBB (right bundle branch block) with left or right axis deviation. I need to explain to you that patients with this block are safe to undergo anesthesia. I would have been happy if an ECG had been attached. If LBBB (left bundle branch block) is associated with the bifascicular block, only then does the risk increase, which is a complete heart block that needs a pacemaker.
In brief, there is no added risk due to a bifascicular block. Please tell the anesthetist about this condition so that he can keep a temporary pacemaker ready if the need arises. There is just a one percent chance of complete heart block.
I hope that you get your answer.
Please let me know if you need any help.
Thank you.
Patient's Query
Hi doctor,
I would like to send you my most sincere gratitude for your prompt excellent and precise reply. I value such clarity of communication with other professionals very deeply.
I have an ECG here somewhere, but since you say the anesthetist will not feel concerned or reluctant even if there is associated LBBB because he will have a temporary pacemaker ready in the unlikely case of complete heart block, I think you have answered my concern fully.
I am so impressed, that I will be recommending you to a colleague who has some concerns regarding anesthesia/surgery when I return after my surgery.
Please let me know about your availability. I wish you the very best, and look forward to hearing from you.
Thank you.
Hello,
Welcome back to icliniq.com.
I am glad for your comments and appreciation. We are available on the phone as well, please feel free to call back. Do not worry you will be fine. All the best.
I hope that you get your answer.
Please let me know if you need any help.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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