Right bundle branch block
heart block in the electrical conduction system
A right bundle branch block (RBBB) is a heart block in the right bundle branch of the electrical conduction system.
During a right bundle branch block, the right ventricle is not directly activated by impulses traveling through the right bundle branch. However, the left bundle branch still normally activates the left ventricle. These impulses can then travel through the myocardium of the left ventricle to the right ventricle and depolarize the right ventricle this way. As conduction through the myocardium is slower than conduction through the bundle of His-Purkinje fibres, the QRS complex is seen to be widened. The QRS complex often shows an extra deflection that reflects the rapid depolarisation of the left ventricle, followed by the slower depolarisation of the right ventricle.
Incomplete right bundle branch block
An incomplete right bundle branch block (IRBBB) is a conduction abnormality in the right bundle branch block. While a complete RBBB has a QRS duration of 120 ms or more, an incomplete RBBB has a wave duration between 100 and 120 ms. It has a relatively high prevalence, a study conducted on young Swiss military conscripts with a mean age of 19 years found a prevalence of 13.5%. It affects patients of all ages, more commonly males and athletes, however it is not always a benign finding.
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