Right bundle branch block

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Right bundle branch block
File:Right bundle branch block (RBBB) of the human heart.svg
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].

File:Right bundle branch block ECG characteristics.svg
Right bundle branch block ECG characteristics

Pathophysiology[edit]

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[edit]

File:Cardiogram indicating right bundle branch block with tachycardia.jpg
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[3].

Clinical Significance and Management[edit]

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[edit]

  1. "Right bundle branch block: can it be diagnosed from the 12 lead ECG?".Heart.2005;91(8)
    1153-1157.doi:10.1136/hrt.2004.057901.Full text.
  2. , Goldberger's Clinical Electrocardiography: A Simplified Approach. online version, Elsevier, 2018, ISBN 978-0-323-47988-9,
  3. "Right bundle branch block: can it be diagnosed from the 12 lead ECG?".Heart.2005;91(8)
    1153-1157.doi:10.1136/hrt.2004.057901.Full text.
  4. Electrocardiogram (ECG or EKG)(link). American Heart Association. Accessed 2023-06-20.