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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.
The criteria to diagnose a right bundle branch block on the electrocardiogram: The heart rhythm must originate above the ventricles (i.e., sinoatrial node, atria or atrioventricular node) to activate the conduction system at the correct point. The QRS duration must be more than 100 ms (incomplete block) or more than 120 ms (complete block). [9]
Left bundle branch block (LBBB) is a conduction abnormality in the heart that can be seen on an electrocardiogram (ECG). [1] In this condition, activation of the left ventricle of the heart is delayed, which causes the left ventricle to contract later than the right ventricle .
Tachycardia-dependent bundle branch block (TDBBB) can affect either ventricle in the heart, and occurs when the heart's rate of contraction reaches an elevated level and becomes uncoupled from the heart's refractory period (the time it takes for a cardiac cell to "reset" for future contraction).
Normal variation causing LAD is an age-related physiologic change. Conduction defects such as left bundle branch block or left anterior fascicular block can cause LAD on the ECG. Pre-excitation syndrome as well as congenital heart diseases such as atrial septal defect, endocardial cushion defects can also cause LAD on ECG.
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.
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