Right bundle branch block

Question 1

What is right bundle branch block?

Answer 1

As metrical activity travels down the bundle of his from the AV node to the bundle branch, the RBBB is blocked, delaying depolarisation of the right ventricle.

Question 2

How do I recognise RBBB?

Answer 2

• QRS complex greater then 0.12 seconds or 3 small squares.
• Positive QRS complex in V1 with rSR pattern or ‘M shape’
• Slurred S-wave in LI, aVL, V5 and V6- These are the lateral leads.

Question 3

Leads RBBB can be recognised in?

Answer 3

All but the best leads to observe are LII, V1 > V4

Question 4

Signs and symptoms of RBBB?

Answer 4

May be rare but can include:

• Chest pain
• Shortness of breath
• Dyspnoea

Question 5

Significance of RBBB ?

Answer 5

• Patients can live normal lives with RBBB.
• Important to check if they have a diagnoses of it already. If not may require further investigation.

Question 6

What is an incomplete bundle branch block?

Answer 6

An incomplete bundle branch block is an RSR pattern with a QRS duration of <0.12 seconds or 3 small squares

Question 7

Treatment of RBBB in prehospital care

Answer 7

No clinical significant difference between the two definition and will require treatment as per presentation.