Hello, I am Dr Mody and I will l be addressing your concern. The basic indication for pacemaker for your father is low LVEF ( when less than 30%-35%) to prevent sudden cardiac death particularly when the ekg too has high risk features . Moderate PAH is not a contraindications for pacemaker. Pacemaker are of many types, and if your ecg particularly has Lbbb pattern and qrs more than 120, and low ef, your doctors may be considering a pacemaker for cardiac resynchronisation to improve LVEF. However in your father's case I would consider a myocardial perfusion scan for viable myocardium, of present an angiogram and revascularisation of lad territory ( Mitral regurgitation estimation and correction) and pacemaker if particular indication for the same. Regards Dr Priyank Mody
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