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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.
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.
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]
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).
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 ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the ...
An electrophysiology study of the conduction system can help discern the severity of conduction system disease. In an electrophysiology study, trifascicular block due to AV nodal disease is represented by a prolonged AH interval (denoting prolonged time from impulse generation in the atria and conduction to the bundle of His) with a relatively preserved HV interval (denoting normal conduction ...
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]
Bifascicular block is a combination of right bundle branch block and either left anterior fascicular block or left posterior fascicular block. Conduction to the ventricle would therefore be via the remaining fascicle. The ECG will show typical features of RBBB plus either left or right axis deviation. [7] [8]