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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
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
J Am Coll Cardiol 2019 Aug 20;74(7):e51-e156. Epub 2018 Nov 6 doi: 10.1016/j.jacc.2018.10.044. PMID: 30412709

Recent clinical studies

Etiology

Bilateral Bundle Branch Block.
Gilge JL, Padanilam BJ
Cardiol Clin 2023 Aug;41(3):393-397. doi: 10.1016/j.ccl.2023.03.011. PMID: 37321689
Bilateral Bundle Branch Block.
Gilge JL, Padanilam BJ
Card Electrophysiol Clin 2021 Dec;13(4):685-689. Epub 2021 Sep 23 doi: 10.1016/j.ccep.2021.06.008. PMID: 34689895
A Novel Pacing Strategy With Low and Stable Output: Pacing the Left Bundle Branch Immediately Beyond the Conduction Block.
Huang W, Su L, Wu S, Xu L, Xiao F, Zhou X, Ellenbogen KA
Can J Cardiol 2017 Dec;33(12):1736.e1-1736.e3. Epub 2017 Sep 22 doi: 10.1016/j.cjca.2017.09.013. PMID: 29173611
Hemiblocks revisited.
Elizari MV, Acunzo RS, Ferreiro M
Circulation 2007 Mar 6;115(9):1154-63. doi: 10.1161/CIRCULATIONAHA.106.637389. PMID: 17339573
Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report.
Brugada P, Brugada J
J Am Coll Cardiol 1992 Nov 15;20(6):1391-6. doi: 10.1016/0735-1097(92)90253-j. PMID: 1309182

Diagnosis

Bilateral Bundle Branch Block.
Gilge JL, Padanilam BJ
Cardiol Clin 2023 Aug;41(3):393-397. doi: 10.1016/j.ccl.2023.03.011. PMID: 37321689
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
His Bundle Pacing.
Vijayaraman P, Chung MK, Dandamudi G, Upadhyay GA, Krishnan K, Crossley G, Bova Campbell K, Lee BK, Refaat MM, Saksena S, Fisher JD, Lakkireddy D; ACC’s Electrophysiology Council
J Am Coll Cardiol 2018 Aug 21;72(8):927-947. doi: 10.1016/j.jacc.2018.06.017. PMID: 30115232
Defining left bundle branch block in the era of cardiac resynchronization therapy.
Strauss DG, Selvester RH, Wagner GS
Am J Cardiol 2011 Mar 15;107(6):927-34. doi: 10.1016/j.amjcard.2010.11.010. PMID: 21376930

Therapy

Adaptive versus conventional cardiac resynchronisation therapy in patients with heart failure (AdaptResponse): a global, prospective, randomised controlled trial.
Wilkoff BL, Filippatos G, Leclercq C, Gold MR, Hersi AS, Kusano K, Mullens W, Felker GM, Kantipudi C, El-Chami MF, Essebag V, Pierre B, Philippon F, Perez-Gil F, Chung ES, Sotomonte J, Tung S, Singh B, Bozorgnia B, Goel S, Ebert HH, Varma N, Quan KJ, Salerno F, Gerritse B, van Wel J, Schaber DE, Fagan DH, Birnie D; AdaptResponse investigators
Lancet 2023 Sep 30;402(10408):1147-1157. Epub 2023 Aug 24 doi: 10.1016/S0140-6736(23)00912-1. PMID: 37634520
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
Clinical outcomes of conduction system pacing compared to biventricular pacing in patients requiring cardiac resynchronization therapy.
Vijayaraman P, Zalavadia D, Haseeb A, Dye C, Madan N, Skeete JR, Vipparthy SC, Young W, Ravi V, Rajakumar C, Pokharel P, Larsen T, Huang HD, Storm RH, Oren JW, Batul SA, Trohman RG, Subzposh FA, Sharma PS
Heart Rhythm 2022 Aug;19(8):1263-1271. Epub 2022 Apr 29 doi: 10.1016/j.hrthm.2022.04.023. PMID: 35500791
His Bundle Pacing.
Vijayaraman P, Chung MK, Dandamudi G, Upadhyay GA, Krishnan K, Crossley G, Bova Campbell K, Lee BK, Refaat MM, Saksena S, Fisher JD, Lakkireddy D; ACC’s Electrophysiology Council
J Am Coll Cardiol 2018 Aug 21;72(8):927-947. doi: 10.1016/j.jacc.2018.06.017. PMID: 30115232
Defining left bundle branch block in the era of cardiac resynchronization therapy.
Strauss DG, Selvester RH, Wagner GS
Am J Cardiol 2011 Mar 15;107(6):927-34. doi: 10.1016/j.amjcard.2010.11.010. PMID: 21376930

Prognosis

Catheter-induced right bundle branch block: Practical implications for the cardiac electrophysiologist.
Ali H, Lupo P, Foresti S, De Ambroggi G, Anderson RH, De Lucia C, Turturiello D, Paganini EM, Bessi R, Contrafatto I, Farghaly AAA, Cristiano E, Cappato R
J Cardiovasc Electrophysiol 2023 Nov;34(11):2316-2329. Epub 2023 Sep 1 doi: 10.1111/jce.16050. PMID: 37655997
Right Bundle Branch Block: Current Considerations.
Ikeda T
Curr Cardiol Rev 2021;17(1):24-30. doi: 10.2174/1573403X16666200708111553. PMID: 32640959Free 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
A Novel Pacing Strategy With Low and Stable Output: Pacing the Left Bundle Branch Immediately Beyond the Conduction Block.
Huang W, Su L, Wu S, Xu L, Xiao F, Zhou X, Ellenbogen KA
Can J Cardiol 2017 Dec;33(12):1736.e1-1736.e3. Epub 2017 Sep 22 doi: 10.1016/j.cjca.2017.09.013. PMID: 29173611
Hemiblocks revisited.
Elizari MV, Acunzo RS, Ferreiro M
Circulation 2007 Mar 6;115(9):1154-63. doi: 10.1161/CIRCULATIONAHA.106.637389. PMID: 17339573

Clinical prediction guides

Catheter-induced right bundle branch block: Practical implications for the cardiac electrophysiologist.
Ali H, Lupo P, Foresti S, De Ambroggi G, Anderson RH, De Lucia C, Turturiello D, Paganini EM, Bessi R, Contrafatto I, Farghaly AAA, Cristiano E, Cappato R
J Cardiovasc Electrophysiol 2023 Nov;34(11):2316-2329. Epub 2023 Sep 1 doi: 10.1111/jce.16050. PMID: 37655997
Fascicular Blocks: Update 2019.
Elizari MV
Curr Cardiol Rev 2021;17(1):31-40. doi: 10.2174/1573403X16666200708111928. PMID: 32640960Free PMC Article
His Bundle Pacing.
Vijayaraman P, Chung MK, Dandamudi G, Upadhyay GA, Krishnan K, Crossley G, Bova Campbell K, Lee BK, Refaat MM, Saksena S, Fisher JD, Lakkireddy D; ACC’s Electrophysiology Council
J Am Coll Cardiol 2018 Aug 21;72(8):927-947. doi: 10.1016/j.jacc.2018.06.017. PMID: 30115232
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

Recent systematic reviews

Left Bundle Branch Pacing: A Paradigm Shift in Physiological Pacing for Patients With Atrioventricular Block and Preserved Left Ventricular Systolic Function, A Systematic Review and Meta-analysis.
Al Hennawi H, Khan MK, Sohail A, Ashraf MT, Islam M, Sadiq U, McCaffrey J
Curr Probl Cardiol 2023 Dec;48(12):101983. Epub 2023 Jul 19 doi: 10.1016/j.cpcardiol.2023.101983. PMID: 37473943
The prognostic significance of bundle branch block in acute heart failure: a systematic review and meta-analysis.
Aguiló O, Castells X, Miró Ò, Mueller C, Chioncel O, Trullàs JC
Clin Res Cardiol 2023 Aug;112(8):1020-1043. Epub 2022 Sep 18 doi: 10.1007/s00392-022-02105-z. PMID: 36116092
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

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