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right bundle branch block (RBBB)
An ECG change characterized by an intraventricular conduction delay affecting the right ventricular wall. Acute occurrences most commonly result from myocardial ischemia.
Etiology:
1) myocardial ischemia (most common)
2) hypertension
3) rheumatic heart disease
4) can be found in normal individuals
Special laboratory:
- electrocardiogram
1) prolonged QRS
2) triphasic complexes (bifid QRS)
3) lead V1: rsR'
4) lead V6: qRs
*RBBB tends to decrease voltage, thus can identify LVH.
*The initial septal activation is from the left to right & anteriorly. Right ventricular activation occurs following completion of the left ventricular activation. Delayed activation of the right ventricle is responsible for the rsR' pattern in V1 & the round deep S wave in V6.
General
bundle branch block
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