Right bundle branch block

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.

Right bundle branch block ECG characteristics

Pathophysiology

Right bundle branch block

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.

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.

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.

References

Right bundle branch block Resources
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