Right bundle branch block

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Right bundle branch block
Classification and external resources
ICD-10 I45.1
DiseasesDB 11620
eMedicine ped/2500 
ECG characteristics of a typical RBBB showing wide QRS complexes with a terminal R wave in lead V1 and slurred S wave in lead V6.
ECG characteristics of a typical RBBB showing wide QRS complexes with a terminal R wave in lead V1 and slurred S wave in lead V6.

A right bundle branch block (RBBB) is a defect in the heart's electrical conduction system.

During a right bundle branch block, the right ventricle is not directly activated by impulses travelling through the right bundle branch. The left ventricle however, is still normally activated by the left bundle branch and these impulses travel through the left ventricle's myocardium to the right ventricle and activate the right ventricle.

ECG diagnosis

The criteria to diagnose a right bundle branch block on the electrocardiogram:

  • The heart rhythm must be supraventricular in origin
  • The QRS duration must be = or > 120 ms
  • There should be a terminal R wave in lead V1 (e.g., R, rR', rsR', rSR' or qR)
  • There should be a slurred S wave in leads I and V6.

The T wave should be deflected opposite the terminal deflection of the QRS complex. This is known as appropriate T wave discordance with bundle branch block. A concordant T wave may suggest ischemia or myocardial infarction.

Prevalence of RBBB increases with age.

See also

Wikipedia content modification information:

  • This page was last modified on 2 September 2008, at 09:01.

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