Right bundle branch block
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| Right bundle branch block | |
|---|---|
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| 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[1].
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[2].
ECG Characteristics
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[3].
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[4].
References
- ↑ , 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,
- ↑ , Goldberger's Clinical Electrocardiography: A Simplified Approach. online version, Elsevier, 2018, ISBN 978-0-323-47988-9,
- ↑ , 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,
- ↑ Electrocardiogram (ECG or EKG)(link). American Heart Association. Accessed 2023-06-20.
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Contributors: Prab R. Tumpati, MD
