From the Guidelines
When explaining a Right Bundle Branch Block (RBBB) to a patient, I would say: "A Right Bundle Branch Block is a condition where the electrical signal that makes your heart beat is delayed on the right side of your heart, as defined by the presence of a RBBB on an electrocardiogram, which is a key data element in the evaluation of heart failure 1." This condition can be present from birth or develop due to various factors such as heart disease, high blood pressure, or heart attacks.
- The electrical system of the heart coordinates how it beats, with special pathways called 'bundles' that carry these signals.
- In the case of RBBB, the right bundle is not conducting electricity normally, causing the right side of the heart to contract slightly later than the left side.
- RBBB is often found incidentally on an ECG and usually doesn't cause symptoms or require treatment if the patient is otherwise healthy.
- However, it's essential to monitor heart health with regular check-ups, and if symptoms like shortness of breath or fatigue develop, additional tests like an echocardiogram may be necessary to check heart function if there are concerns about underlying heart conditions, as noted in the 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay 1.
- The presence of RBBB can also be a predictor for pacemaker implantation after transcatheter aortic valve replacement, as reported in the 2020 ACC expert consensus decision pathway on management of conduction disturbances in patients undergoing transcatheter aortic valve replacement 1. It's crucial to emphasize that while most people with RBBB don't need specific treatment, regular monitoring and follow-up are necessary to ensure the best possible outcomes, as supported by the 2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death 1.
From the Research
Explaining RBBB to a Patient
- A Right Bundle Branch Block (RBBB) is a pattern seen on an electrocardiogram (ECG) that occurs when there is an interruption in the normal electrical activity of the heart 2.
- This interruption alters the normal sequence of activation in the heart, resulting in a characteristic appearance on the ECG, including a widened QRS complex and changes in the directional vectors of the R and S waves 2.
- RBBB is often seen in clinical practice and is generally considered benign, but it can be associated with an increased risk of sudden death in certain patients, particularly those with ST-segment elevation in leads V1 through V3 3.
- Patients with RBBB and this specific ECG pattern may experience arrhythmic events, including sudden death, and may require treatment with an implantable defibrillator to reduce this risk 3.
- It is essential to note that RBBB can have different causes and symptoms, and a thorough diagnosis and evaluation by a healthcare professional are necessary to determine the best course of treatment 2.