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EKG: right bundle branch block

MedGen UID:
576272
•Concept ID:
C0344421
•
Finding
Synonyms: ECG: right bundle branch block; Electrocardiographic right bundle branch block; RBBB; Right Bundle Branch Block; Right bundle branch block (RBBB) on electrocardiogram; Right Bundle Branch Block by ECG Finding; Right Bundle Branch Block by EKG Finding
SNOMED CT: ECG: right bundle branch block (164907000); Right bundle branch block (RBBB) on electrocardiogram (164907000); Electrocardiographic right bundle branch block (164907000); EKG: right bundle branch block (164907000)

Definition

An electrocardiographic finding of a wide QRS complex with evidence of delayed conduction to the right ventricle, manifested by a widened initial portion of the QRS in V1 and V2, a widened S wave in V5, V6, I and aVL, and with QRS duration greater than or equal to 120 ms. An RsR'' complex is typically present in leads V1 and V2. (CDISC) [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVEKG: right bundle branch block

Professional guidelines

PubMed

Fetal Arrhythmia Diagnosis and Pharmacologic Management.
Strasburger JF, Eckstein G, Butler M, Noffke P, Wacker-Gussmann A
J Clin Pharmacol 2022 Sep;62 Suppl 1(Suppl 1):S53-S66. doi: 10.1002/jcph.2129. PMID: 36106782Free PMC Article
2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ, Lee R, Marine JE, McLeod CJ, Oken KR, Patton KK, Pellegrini CN, Selzman KA, Thompson A, Varosy PD
Circulation 2019 Aug 20;140(8):e382-e482. Epub 2018 Nov 6 doi: 10.1161/CIR.0000000000000628. PMID: 30586772
Cardiac Resynchronization Therapy: An Overview on Guidelines.
Boriani G, Nesti M, Ziacchi M, Padeletti L
Card Electrophysiol Clin 2015 Dec;7(4):673-93. Epub 2015 Oct 1 doi: 10.1016/j.ccep.2015.08.015. PMID: 26596811

Recent clinical studies

Etiology

Long-Term Results of His Bundle Pacing.
Subzposh FA, Vijayaraman P
Card Electrophysiol Clin 2018 Sep;10(3):537-542. Epub 2018 Jul 21 doi: 10.1016/j.ccep.2018.05.011. PMID: 30172290
His Bundle Pacing: Is It Ready for Prime Time?
Ezzeddine FM, Dandamudi G
Card Electrophysiol Clin 2018 Mar;10(1):87-98. doi: 10.1016/j.ccep.2017.11.009. PMID: 29428145
Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death.
Basso C, Perazzolo Marra M, Rizzo S, De Lazzari M, Giorgi B, Cipriani A, Frigo AC, Rigato I, Migliore F, Pilichou K, Bertaglia E, Cacciavillani L, Bauce B, Corrado D, Thiene G, Iliceto S
Circulation 2015 Aug 18;132(7):556-66. Epub 2015 Jul 9 doi: 10.1161/CIRCULATIONAHA.115.016291. PMID: 26160859
The Brugada syndrome--an update.
Shimizu W
Intern Med 2005 Dec;44(12):1224-31. doi: 10.2169/internalmedicine.44.1224. PMID: 16415541
The Brugada syndrome.
Naccarelli GV, Antzelevitch C, Wolbrette DL, Luck JC
Curr Opin Cardiol 2002 Jan;17(1):19-23. doi: 10.1097/00001573-200201000-00003. PMID: 11790929

Diagnosis

Right Bundle Branch Block: Current Considerations.
Ikeda T
Curr Cardiol Rev 2021;17(1):24-30. doi: 10.2174/1573403X16666200708111553. PMID: 32640959Free PMC Article
Left bundle branch pacing: A comprehensive review.
Ponnusamy SS, Arora V, Namboodiri N, Kumar V, Kapoor A, Vijayaraman P
J Cardiovasc Electrophysiol 2020 Sep;31(9):2462-2473. Epub 2020 Jul 30 doi: 10.1111/jce.14681. PMID: 32681681
Intraventricular Delay and Blocks.
Leonelli FM, Bagliani G, De Ponti R, Padeletti L
Card Electrophysiol Clin 2018 Jun;10(2):211-231. doi: 10.1016/j.ccep.2018.02.003. PMID: 29784481
Drug therapy in Brugada syndrome.
Márquez MF, Salica G, Hermosillo AG, Pastelín G, Cárdenas M
Curr Drug Targets Cardiovasc Haematol Disord 2005 Oct;5(5):409-17. doi: 10.2174/156800605774370353. PMID: 16248833
The Brugada syndrome.
Naccarelli GV, Antzelevitch C, Wolbrette DL, Luck JC
Curr Opin Cardiol 2002 Jan;17(1):19-23. doi: 10.1097/00001573-200201000-00003. PMID: 11790929

Therapy

Left bundle branch area pacing outcomes: the multicentre European MELOS study.
Jastrzębski M, Kiełbasa G, Cano O, Curila K, Heckman L, De Pooter J, Chovanec M, Rademakers L, Huybrechts W, Grieco D, Whinnett ZI, Timmer SAJ, Elvan A, Stros P, Moskal P, Burri H, Zanon F, Vernooy K
Eur Heart J 2022 Oct 21;43(40):4161-4173. doi: 10.1093/eurheartj/ehac445. PMID: 35979843Free PMC Article
Long-Term Results of His Bundle Pacing.
Subzposh FA, Vijayaraman P
Card Electrophysiol Clin 2018 Sep;10(3):537-542. Epub 2018 Jul 21 doi: 10.1016/j.ccep.2018.05.011. PMID: 30172290
His bundle pacing.
Payne J, Garlitski AC, Weinstock J, Homoud M, Madias C, Estes NAM
J Interv Card Electrophysiol 2018 Aug;52(3):323-334. Epub 2018 Aug 13 doi: 10.1007/s10840-018-0412-5. PMID: 30105429
His bundle pacing: Initial experience and lessons learned.
Deshmukh A, Deshmukh P
J Electrocardiol 2016 Sep-Oct;49(5):658-63. Epub 2016 Jul 11 doi: 10.1016/j.jelectrocard.2016.07.005. PMID: 27591359
The Brugada syndrome.
Naccarelli GV, Antzelevitch C, Wolbrette DL, Luck JC
Curr Opin Cardiol 2002 Jan;17(1):19-23. doi: 10.1097/00001573-200201000-00003. PMID: 11790929

Prognosis

Right Bundle Branch Block: Current Considerations.
Ikeda T
Curr Cardiol Rev 2021;17(1):24-30. doi: 10.2174/1573403X16666200708111553. PMID: 32640959Free PMC Article
Long-Term Results of His Bundle Pacing.
Subzposh FA, Vijayaraman P
Card Electrophysiol Clin 2018 Sep;10(3):537-542. Epub 2018 Jul 21 doi: 10.1016/j.ccep.2018.05.011. PMID: 30172290
His bundle pacing.
Payne J, Garlitski AC, Weinstock J, Homoud M, Madias C, Estes NAM
J Interv Card Electrophysiol 2018 Aug;52(3):323-334. Epub 2018 Aug 13 doi: 10.1007/s10840-018-0412-5. PMID: 30105429
Intraventricular Delay and Blocks.
Leonelli FM, Bagliani G, De Ponti R, Padeletti L
Card Electrophysiol Clin 2018 Jun;10(2):211-231. doi: 10.1016/j.ccep.2018.02.003. PMID: 29784481
The Brugada syndrome.
Naccarelli GV, Antzelevitch C, Wolbrette DL, Luck JC
Curr Opin Cardiol 2002 Jan;17(1):19-23. doi: 10.1097/00001573-200201000-00003. PMID: 11790929

Clinical prediction guides

Reversion of cardiac memory during left bundle branch pacing.
Zhong C, Jiang Z, Zhou X, Shan Q
J Electrocardiol 2020 Mar-Apr;59:81-83. Epub 2020 Jan 7 doi: 10.1016/j.jelectrocard.2020.01.001. PMID: 32023497
When the bundle skips a beat….
Buttà C, Crea P, Cimmino M, Ranieri F, Oreto G
J Cardiovasc Med (Hagerstown) 2020 Feb;21(2):153-155. doi: 10.2459/JCM.0000000000000865. PMID: 31460888
Non-invasive cardiac mapping for non-response in cardiac resynchronization therapy.
Strik M, Ploux S, Jankelson L, Bordachar P
Ann Med 2019 Mar;51(2):109-117. Epub 2019 May 23 doi: 10.1080/07853890.2019.1616109. PMID: 31094217Free PMC Article
Intraventricular Delay and Blocks.
Leonelli FM, Bagliani G, De Ponti R, Padeletti L
Card Electrophysiol Clin 2018 Jun;10(2):211-231. doi: 10.1016/j.ccep.2018.02.003. PMID: 29784481
Cellular and ionic mechanisms responsible for the Brugada syndrome.
Antzelevitch C, Yan GX
J Electrocardiol 2000;33 Suppl:33-9. doi: 10.1054/jelc.2000.20321. PMID: 11265734

Recent systematic reviews

Left bundle branch pacing versus biventricular pacing for cardiac resynchronization therapy: A systematic review and meta-analysis.
Parlavecchio A, Vetta G, Caminiti R, Coluccia G, Magnocavallo M, Ajello M, Pistelli L, Dattilo G, Foti R, Carerj S, Della Rocca DG, Crea P, Palmisano P
Pacing Clin Electrophysiol 2023 May;46(5):432-439. Epub 2023 Apr 10 doi: 10.1111/pace.14700. PMID: 37036831
Arrhythmias and Conduction Disturbances in Patients with Systemic Sclerosis-A Systematic Literature Review.
Vrancianu CA, Gheorghiu AM, Popa DE, Chan JSK, Satti DI, Lee YHA, Hui JMH, Tse G, Ancuta I, Ciobanu A, Bojinca M
Int J Mol Sci 2022 Oct 26;23(21) doi: 10.3390/ijms232112963. PMID: 36361752Free PMC Article
Conduction System Pacing for Cardiac Resynchronization Therapy.
Herweg B, Welter-Frost A, Wilson Ii DR, Vijayaraman P
Card Electrophysiol Clin 2022 Jun;14(2):297-310. Epub 2022 May 25 doi: 10.1016/j.ccep.2021.12.005. PMID: 35715087
The electrocardiogram characteristics and pacing parameters of permanent left bundle branch pacing: a systematic review and meta-analysis.
Gao J, Zhang BH, Zhang N, Sun M, Wang R
J Interv Card Electrophysiol 2022 Jan;63(1):215-224. Epub 2021 Jun 26 doi: 10.1007/s10840-021-01000-3. PMID: 34173915
Systematic review of cardiac electrical disease in Kearns-Sayre syndrome and mitochondrial cytopathy.
Kabunga P, Lau AK, Phan K, Puranik R, Liang C, Davis RL, Sue CM, Sy RW
Int J Cardiol 2015 Feb 15;181:303-10. Epub 2014 Dec 13 doi: 10.1016/j.ijcard.2014.12.038. PMID: 25540845

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