Right bundle branch block

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Right bundle branch block
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Often asymptomatic, may include syncope, palpitations
Complications	Heart failure, arrhythmia
Onset	Can occur at any age
Duration	Can be transient or permanent
Types	N/A
Causes	Coronary artery disease, myocardial infarction, cardiomyopathy, congenital heart disease
Risks	Hypertension, diabetes mellitus, smoking, family history
Diagnosis	Electrocardiogram (ECG)
Differential diagnosis	Left bundle branch block, bifascicular block, trifascicular block
Prevention	N/A
Treatment	Often none required, pacemaker if symptomatic
Medication	N/A
Prognosis	Generally good if isolated
Frequency	Common, increases with age
Deaths	N/A

Right Bundle Branch Block (RBBB) represents an electrocardiographic (ECG) pattern indicating impaired electrical conduction to the right ventricle. It is marked by a distinctive widened QRS complex with a duration of 120 milliseconds or greater<ref>,

 Right bundle branch block: can it be diagnosed from the 12 lead ECG?, 
 Heart, 
 2005,
 Vol. 91(Issue: 8),
 pp. 1153-1157,
 DOI: 10.1136/hrt.2004.057901,
 
 
 
 Full text,</ref>.

Right bundle branch block ECG characteristics

Pathophysiology

RBBB is caused by a disruption in the normal function of the right bundle branch, one of the pathways that electrical signals use to travel within the heart. This disruption results in the right ventricle being activated later than the left, leading to the classic ECG changes<ref>,

 Goldberger's Clinical Electrocardiography: A Simplified Approach. online version, 
  
 Elsevier, 
 2018, 
  
  
 ISBN 978-0-323-47988-9,</ref>.

ECG Characteristics

Cardiogram indicating right bundle branch block with tachycardia

Specific ECG findings associated with RBBB include:

• An expanded QRS complex, greater than or equal to 120 ms.
• A widened initial portion of the QRS complex in leads V1 and V2.
• A widened S wave in leads V5, V6, I, and aVL.
• Presence of an rsR' pattern typically in leads V1 and V2<ref>,

 Right bundle branch block: can it be diagnosed from the 12 lead ECG?, 
 Heart, 
 2005,
 Vol. 91(Issue: 8),
 pp. 1153-1157,
 DOI: 10.1136/hrt.2004.057901,
 
 
 
 Full text,</ref>.

Clinical Significance and Management

In some cases, RBBB may occur without underlying heart disease and may not have significant health implications. However, it can be associated with conditions like heart disease, pulmonary embolism, myocardial infarction, or cardiomyopathy, and therefore should prompt further evaluation in certain contexts. The treatment of RBBB involves addressing the underlying cause, if any, rather than the block itself<ref>

Electrocardiogram (ECG or EKG)(link). American Heart Association.

Accessed 2023-06-20.

</ref>.

References

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