What Is a Right Bundle Branch Block?

Right bundle branch block (RBBB) is referred to as right bundle branch block. Right bundle branch block can be seen in normal people, but less. There are more children and young people, and incomplete right bundle branch block is more common. About 1% of normal young people have incomplete right bundle branch block. Patients with incomplete right bundle branch block can be found in congenital heart disease, especially with atrial septal defect, and also can be found in ventricular septal defect with double ventricular enlargement, pulmonary vein malformation, etc .; about mitral stenosis in rheumatic heart disease 1/3 can appear. The right bundle branch block itself does not produce obvious hemodynamic abnormalities, so it is often clinically asymptomatic. If symptoms appear, they are mostly the symptoms of the primary disease.

Basic Information

English name

right bundle-branch block

Visiting department

Cardiology

Multiple groups

Children, young people

Common locations

heart

Causes of right bundle branch block

1. Right bundle branch block can be seen in normal people, but less.

2. Incomplete right bundle branch block often occurs in the following pathophysiological conditions: congenital cardiovascular malformations; some coronary heart disease and cardiomyopathy; some chronic lung diseases, mild right ventricular hypertrophy or dilatation.

3. The vast majority of patients with complete right bundle branch block have organic heart disease, such as coronary heart disease, hypertension heart disease, rheumatic heart disease, cardiomyopathy, pulmonary heart disease, congenital heart disease, high Kalemia, Lev's disease, Lenegre's disease or after open heart surgery.

Clinical manifestations of right bundle branch block

The right bundle branch block itself does not produce significant hemodynamic abnormalities, so it is often clinically asymptomatic. If symptoms appear, they are mostly the symptoms of the primary disease.

Right bundle branch block

Mainly rely on ECG examination diagnosis.

1. Characteristics of complete right bundle branch block electrocardiogram

(1) The QRS waves of leads V1 and V2 (or leads V3R and V4R) of the right chest are rsR , rSR , rsr , or M, and the R wave is usually higher than the r wave; Notched R wave.

(2) The S-waves of leads V5 and V6 are significantly broad, with a time limit 0.04s, but not deep. Leads and aVR show qR waves. The R waves tend to widen but not high. Leads , aVL and are mostly broad and not deep S waves.

(3) QRS time limit 0.12s.

(4) When there are notched R waves in leads V1 and V2, the R wave peak time (ventricular wall excitation time) is 0.05s. The R-peak times of leads V5 and V6 are normal.

(5) The change of ST-T is opposite to the direction of the QRS wave terminal vector, that is, the ST segment of leads V1 and V2 is depressed and the T wave is inverted, while the ST segment of leads V5 and V6 is elevated and the T wave is upright.

2. Typical ECG characteristics of incomplete right bundle branch block

(1) The QRS waves of leads V1 and V2 of the right chest lead are rsR , rsr , rSR , or M-type. Its R 'wave is usually higher than the r wave.

(2) The S waves of leads V5, V6, and widen without deepening.

(3) QRS time limit is 0.12s.

Right bundle branch block treatment

The treatment of right bundle branch block is mainly for the treatment of the etiology and underlying diseases. Because the right bundle branch block itself has no significant effect on hemodynamics, it is often asymptomatic in the clinic and no special treatment is required. Follow-up observations (including regular inspections of electrocardiogram, echocardiography, etc.) should be performed regularly.

However, the pacemaker should be considered if the following situations occur: People with black Mongolia, syncope, and A-S syndrome who are definitely related to the right bundle branch block. The ECG manifested as complete right bundle branch block combined with left posterior branch block and / or left anterior branch block such as double branch and triple beam branch blocks.

Prognosis of right bundle branch block

Right bundle branch block is seen in people without organic heart disease, and the prognosis is good when it exists alone. The prognosis of patients with indoor block with definite organic heart disease is related to the extent of the damage and ventricular function.

Prevention of right bundle branch block

1. Actively treat the cause, such as treating coronary artery disease, hypertension, pulmonary heart disease, myocarditis, etc., to prevent the occurrence and development of blockade.

2. Work and rest appropriately, have a moderate diet, live on time, and participate in physical exercise appropriately.