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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.
A bundle branch block can be diagnosed when the duration of the QRS complex on the ECG exceeds 120 ms. A right bundle branch block typically causes prolongation of the last part of the QRS complex and may shift the heart's electrical axis slightly to the right.
A 12-lead ECG of a woman with Ebstein's anomaly: The ECG shows signs of right atrial enlargement, best seen in V1. Other P waves are broad and tall, these are termed "Himalayan" P waves. Also, a right bundle-branch block pattern and a first-degree atrioventricular block (prolonged PR-interval) due to intra-atrial conduction delay are seen.
There are two branches of the bundle of His: the left bundle branch and the right bundle branch, both of which are located along the interventricular septum. The left bundle branch further divides into the left anterior fascicle and the left posterior fascicle. These structures lead to a network of thin filaments known as Purkinje fibers.
An intraventricular block is a heart conduction disorder — heart block of the ventricles of the heart. [1] An example is a right bundle branch block, right fascicular block, bifascicular block, trifascicular block. [2] [3]
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.
Right or left ventricular hypertrophy [3] Intraventricular conduction abnormalities (e.g., right or left bundle branch block, WPW, etc.) [3] Hypothermia [4] Tachycardia [4] Reciprocal ST elevation [4] Mitral valve prolapse [3] Central nervous system disease, [3] such as stroke [5]
If an MI is presented with ECG evidence of an ST elevation known as STEMI, or if a bundle branch block is similarly presented, then reperfusion therapy is necessary. In the absence of an ST elevation, a non-ST elevation MI, known as an NSTEMI , or an unstable angina may be presumed (both of these are indistinguishable on initial evaluation of ...