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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.
Bifascicular block is characterized by right bundle branch block with left anterior fascicular block, or right bundle branch block with left posterior fascicular block on electrocardiography. Complete heart block could be the cause of syncope that is otherwise unexplained if bifascicular block is seen on electrocardiography. [1]
This is a combination of right bundle branch block with either left anterior fascicular block or left posterior fascicular block together with a first degree AV block. Tachycardia-dependent bundle branch block; A simple way to quickly differentiate between the two types is to note the deflection of the QRS complex in the V1 lead. A (V1) QRS ...
The bundle branches were separately described by Retzer and Braeunig as early as 1904, but their physiological function remained unclear and their role in the electrical conduction system of the heart remained unknown until Sunao Tawara published his monograph on Das Reizleitungssystem des Säugetierherzens (English: The Conduction System of the Mammalian Heart) in 1906. [4]
Intraventricular conduction delay seen in precordial/chest leads with QRS duration 100 ms. An EKG of a 25-year-old male. Intraventricular conduction delays (IVCD) are conduction disorders seen in intraventricular propagation of supraventricular impulses resulting in changes in the QRS complex duration or morphology, or both.
Sinus rhythm (rate = 100/min) with 3:2 and 2:1 Type II AV block; right bundle branch block Sinus tachycardia with complete AV block and resulting junctional escape. Following the path of the electrical signals, the places where conduction can be blocked give rise to different kinds of heart blocks:
So with right bundle branch block, the right ventricle contracts late. If the block happened to be on the left side instead, a left bundle branch block, the signal would be delayed on that side and so the right ventricle would contract first, and then the left ventricle would contract late.
The most literal meaning of trifascicular block is complete heart block: all three fascicles are blocked. A second, and clinically distinct, definition of trifascicular block is a circumstance in which right bundle branch block (RBBB) and left bundle branch block occur in the same patient, but at distinct points in time.