Hello doctor, I am 60 years male. I have a BMI of 33. I have bifascicular bundle block. I take Salbutamol and Fluticasone (Relvar) puffers for asthma, which is lifelong. I have seen my GP and my cardiologist and 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. That is, I am here seeking a basic outline of what will be the anesthetist's approach, given bifascicular block. I am an academic and 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 peri-operative 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.
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 was attached. If LBBB (left bundle branch block) is associated with the bifascicular block, only then the risk increases, which is complete heart block which needs a pacemaker. In brief, there is no added risk due to bifascicular block. Please tell the anesthetist about this condition so that he keeps a temporary pacemaker ready if the need arises. There is just a 1 % chance of complete heart block. For more information consult an anesthesiologist online -->