A right bundle branch block (RBBB) refers to a total or partial blockage of the right branch of the heart’s conduction system. Many people have had RBBB for years without knowing it. However, an RBBB that develops after a heart attack in a previously normal heart is a matter of concern.
In people with a structurally normal heart, RBBB is not a concern since they won’t experience any symptoms, which means treatment is not required for many cases. However, people who simultaneously experience other heart or lung conditions may need to treat these underlying conditions.
In some cases, RBBB could be a warning sign for some severe heart conditions, such as:
- Myocarditis (infection of the heart muscle by bacteria or viruses)
- Myocardial infarction (heart attack)
- Congenital heart defects
- Lenègre disease or Lev disease (acquired complete heart block)
- Cardiomyopathy (diseases of heart muscle)
- Cor pulmonale (right-sided heart failure)
- Pseudo right bundle branch block (inherited arrhythmia syndromes)
Besides the above, other conditions that an RBBB may indicate include:
- Pulmonary embolism (blood clot in the leg)
- Pulmonary hypertension (high blood pressure in the lung arteries)
- Hyperkalemia (high potassium level)
- Right heart catheterizations and ethanol ablation
- Chronic lung disease
- Interventional or surgical procedures on the heart
What is the right bundle branch block?
Right bundle branch block refers to the heart’s inability to conduct electric signals. It is usually harmless unless accompanied by severe heart disease.
The heart’s conduction system
The heart has four chambers:
- Two upper, called atria
- Two lower, called ventricles
In a healthy heart, the electrical signal originates in the sinoatrial node (SA node). The SA node is present in the upper right chamber of the heart. The signal then travels through the left atrium to the ventricles.
Two groups of fibers called the right bundle branch and left bundle branch aids the transfer of signal from the atria to the ventricles. The right bundle branch sends the signal to the right ventricle of the heart.
When there is a block in the right bundle branch, the signals fail to reach the ventricles through the usual pathway. On the contrary, the signal must pass through the left side before entering the right ventricles. As a result, the ventricle takes some time to contract, causing the heart to eject less blood.
Some of the risk factors that can increase the chance of getting the right bundle branch block include:
- Underlying heart or lung problem
- An interventional heart procedure
What are the complications of the right bundle branch block?
Right bundle branch block (RBBB) blocks the electrical signaling of the heart, so signaling problems can gradually lead to:
- Slower heart rate
- Abnormal heart rhythms
- Altering the electrical activity of hearts
- Shortness of breath
Because RBBB may alter the electrical activity of the heart, it may create obstacles to identify other heart diseases, such as heart attacks. It could cause a delay in the appropriate management of the condition. A further intervention, such as sonography, may be advised.
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Texas Heart Institute. Bundle Branch Block. https://www.texasheart.org/heart-health/heart-information-center/topics/bundle-branch-block/
Cleveland Clinic. Bundle Branch Block. https://my.clevelandclinic.org/health/diseases/16815-bundle-branch-block
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