Right bundle branch block electrocardiogram: Difference between revisions
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{{Right bundle branch block}} | {{Right bundle branch block}} | ||
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==Overview== | ==Overview== | ||
Criteria for complete [[right bundle branch block]] | Criteria for complete [[right bundle branch block]] include: a QRS duration of > .12 seconds, an rSR' pattern with a wide terminal R wave in V1 and a qRS complex with a wide S wave in V6. | ||
== | ==Electrocardiogram== | ||
* The heart rhythm must be supraventricular in origin | * The heart rhythm must be supraventricular in origin | ||
* The QRS axis can be either normal, or right or left axis deviation may be present. | * The QRS axis can be either normal, or right or left axis deviation may be present. | ||
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;For EKG examples of right bundle branch block click [[Right bundle branch block EKG examples|here]]. | ;For EKG examples of right bundle branch block click [[Right bundle branch block EKG examples|here]]. | ||
==References== | ==References== | ||
Revision as of 18:55, 6 February 2013
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Right bundle branch block Microchapters |
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Differentiating Right bundle branch block from other Diseases |
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Diagnosis |
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Right bundle branch block electrocardiogram On the Web |
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American Roentgen Ray Society Images of Right bundle branch block electrocardiogram |
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Risk calculators and risk factors for Right bundle branch block electrocardiogram |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Criteria for complete right bundle branch block include: a QRS duration of > .12 seconds, an rSR' pattern with a wide terminal R wave in V1 and a qRS complex with a wide S wave in V6.
Electrocardiogram
- The heart rhythm must be supraventricular in origin
- The QRS axis can be either normal, or right or left axis deviation may be present.
- The QRS duration must be = or > 120 ms
- For complete RBBB, the patient's age must be taken into account to determine if the duration of the QRS complex is prolonged for the patient's age.
- Maximum QRS durations are 0.07 s for newborns <6 days, 0.08 s for patients aged 1 week to 7 years, and 0.09 s for patients aged 7-15 years.
- For complete RBBB, the patient's age must be taken into account to determine if the duration of the QRS complex is prolonged for the patient's age.
- There should be a terminal R wave in lead V1-V3R (e.g., R, rR', rsR', rSR' or qR')
- This pattern is present because the initial R wave represents septal activation, the S wave represents left ventricular activation, and the R' represents activation of the right ventricle from the septum and left ventricle.
- There should be a slurred S wave in leads I and V6. This represent left ventricular activation.
- Because transmission of the electrical impulse through the left bundle is normal, this results in normal depolarization of the septum and the left ventricle. As a result, there is an initial R wave in lead I and V1 and the Q wave in V6.
The T wave should be deflected opposite the terminal deflection of the QRS complex. This is known as appropriate T wave discordance with bundle branch block. A concordant T wave may suggest ischemia or myocardial infarction.
Below is an electrocardiogram showing the main characteristics of right bundle branch block on lead V1.
The rhythm is sinus. The QRS is wide (>120ms.) and the axis is markedly negative. There are small R waves in the inferior leads. The recording shows a right bundle branch block and a left anterior fasicular block.
- For EKG examples of right bundle branch block click here.