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A bundle branch block is a partial or complete interruption in the flow of electrical impulses in either of the bundle branches of the heart's electrical system. [1]
So if the block happens on the right side, it’s referred to as a right bundle branch block. So with this type, the electrical signal starts at the SA node, contracts the atria, moves through the AV node, splits at the bundle of His, and then moves down the left bundle branch but is blocked on the right bundle branch.
When a bundle branch or their fascicles becomes injured (by underlying heart disease, myocardial infarction, or cardiac surgery), it may cease to conduct electrical impulses appropriately, resulting in altered pathways for ventricular depolarization. This condition is known as a bundle branch block. [3]
A right bundle branch block (RBBB) is a heart block in the right bundle branch of the electrical conduction system. [1] During a right bundle branch block, the right ventricle is not directly activated by impulses traveling through the right bundle branch. However, the left bundle branch still normally activates the left ventricle.
Any abnormality of conduction takes longer and causes "widened" QRS complexes. In bundle branch block, there can be an abnormal second upward deflection within the QRS complex. In this case, such a second upward deflection is referred to as R′ (pronounced "R prime"). This would be described as an RSR′ pattern.
Some BBB are permanent and involve a complete bundle blockage while others are dependent on the underlying activity of the heart. [1] For example, certain situations of excessive or reduced heart rate (tachycardia or bradycardia, respectively) can cause a BBB known as a rate-dependent bundle branch block (RDBBB). This manifests in a similar ...
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A bundle branch block either LBBB or RBBB, (although RBBB is known to be associated only with S1 split), will produce continuous splitting but the degree of splitting will still vary with respiration. When the pulmonary valve closes before the aortic valve, this is known as a "paradoxically split S 2 ". [6]