Right bundle branch block causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

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Causes

• Acute pulmonary embolism - acute rise in right ventricular pressures
• Atrial septal defect
• Blunt trauma
• Cardiomyopathy
• COPD
• Cor pulmonale - chronically increased right ventricular pressure and/or right ventricular hypertrophy
• Coronary heart disease
• Familial
• Hypertension
• Lenegre's disease
• Lev's disease
• Myocardial infarction
• Myocarditis
• Polymyositis
• Prenatal exposure to HIV type 1 may cause right anterior hemiblock.
• Surgery for correction of congenital heart disease is the most common cause of RBBB among children in the United States. This includes surgery for repair of an isolated VSD or another congenital heart disease that includes a VSD (eg, double-chambered right ventricle, AV canal defect, or tetralogy of Fallot). The incidence of RBBB varies and ranges from 25-81% after repair of a VSD to 60-100% after repair of tetralogy of Fallot. The risk of RBBB after surgery varies depending upon the proximity of the VSD to the His-Purkinje system.
• Valvular heart disease

Transient RBBB

• Hyperkalemia
• Mechanical damage during right heart catheterization - observed in 5% of the patients. Resolves when the catheter is removed. Associated LBBB can cause complete heart block in such situations leading to cardiac arrest. A temporary pacemaker is inserted during the procedure in patients with LBBB to prevent sudden cardiac arrest.
• Occasionally following thrombolytic therapy in patients with myocardial infarction and new RBBB
• Pulmonary embolism
• Premature atrial contractions or supraventricular tachycardia may cause a transient form of right bundle branch block. This occurs when a premature impulse is conducted from the AV node to the His bundle while the right bundle branch remains in its refractory period, but the left bundle is not. As a result, conduction down the right bundle branch is delayed or blocked.
• Trauma