This study presents an AI-based model using ECG signals to predict left ventricular systolic dysfunction (LVSD) in pacemaker patients. A 1D convolutional neural network (CNN) combined with large language models processed both sequential ECG data and nonsequential clinical metadata. The model achieved an AUROC of 0.97 on both general and pacemaker-specific datasets, demonstrating its high accuracy. This approach offers a fast, cost-effective alternative to traditional echocardiography, improving LVSD detection in patients with pacemakers.