What Is a Right Bundle Branch Block? Everything to Know

Medically Reviewed By Uzochukwu Ibe, MD, MPH
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A right bundle branch block (RBBB) is an ECG finding. It can occur due to damage to the right bundle branch or another part of the myocardial region. RBBB is common in ECGs among the general population. It occurs in up to 11.3% of the population by age 80. In many cases of RBBB, there may not be any clinical evidence of conditions affecting the heart.

Read on to find out more about RBBB. This guide includes information about what can cause RBBB, related symptoms, diagnosis and treatments for heart conditions, and more.

What causes a right bundle branch block?

There is a deflated balloon in the shape of a heart.
Juan Moyano/Stocksy United

There are three areas of the right bundle branch where damage can occur. This includes:

  • proximal right bundle, which is the most common area where damage occurs
  • distal right bundle
  • terminal right bundle

Damage or stretching in one of these areas can prevent impulses from traveling through the right bundle branch. This shows up on an ECG as a right bundle branch block (RBBB). RBBB is a degenerative disease that is typically slow to progress.

Conditions that may cause RBBB include:

Other possible causes of RBBB include:

  • trauma, such as minor trauma to the chest
  • right heart catheterization
  • structural changes
  • pressure on the right ventricle

Q:

Can anxiety cause a right bundle branch block?

Anonymous

A:

I am not aware of any definite relationship between anxiety and right bundle branch blocks. Anxiety can lead to palpitations and, maybe in the workup of palpitations, which include[s] an ECG, a right bundle branch block may be identified.

However, there is no well-established cause and effect relationship between anxiety and right bundle branch blocks.

Uzochukwu Ibe, MD, MPH Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

What is the difference between a complete vs. incomplete right bundle branch block?

A bundle branch block refers to a widened QRS complex and vector changes in an ECG reading.

An incomplete RBBB has a QRS duration of 100–119 milliseconds (ms). A complete RBBB has a QRS duration of 120 ms or greater.

A typical QRS duration is between 60–100 ms. A 2021 study of 76,220 individuals finds that the median QRS duration was 86 ms.

An incomplete RBBB is a common ECG finding that can occur in people of all ages. It more frequently occurs among males (assigned at birth) and athletes. In most cases, you will not require further tests for an incomplete RBBB unless any other anomalies are present.

A complete RBBB may indicate a more serious complication with the right bundle branch. Your doctor can explain to you what the reading means and may recommend further tests.

Find out more about ECGs.

Are there any symptoms of a right bundle branch block?

You will not usually experience any symptoms with a right bundle branch block (RBBB).

Your doctor will typically identify RBBB when you have an ECG during a checkup or examination.

What are the treatments for a right bundle branch block?

You may not require any treatment if you do not experience any symptoms alongside a right bundle branch block (RBBB).

However, you may require treatment for a heart condition occurring alongside RBBB. This treatment can include cardiac resynchronization therapy (CRT) if you have RBBB with a QRS duration greater than 150 ms.

Cardiac resynchronization therapy

Cardiac resynchronization treatment (CRT) uses a pacemaker to detect irregularities in your heart rate. It emits small pulses of electricity to correct the irregularities and help resynchronize your heart rate.

CRT can help improve blood flow and reduce irregularity in the rhythm of your heart. It may also reduce symptoms of heart failure, such as shortness of breath.

Your doctor can explain any treatments they recommend for heart failure or other heart conditions.

When should I contact a doctor?

Your doctor will usually detect a right bundle branch block (RBBB) during an ECG.

You will typically not have any symptoms with RBBB. However, it is important to contact your doctor as soon as you have concerns about your heart health.

Heart failure does not always cause any symptoms. When they do occur, common symptoms of heart failure can include:

Learn more about symptoms of heart conditions.

How do doctors diagnose the cause of a right bundle branch block?

If your doctor detects a right bundle branch block (RBBB), they may arrange for more tests to check your overall heart health. These tests can assist with diagnosing any underlying heart conditions.

Tests your doctor may arrange to monitor your heart health and determine the possible cause of RBBB include:

Ambulatory ECG involves wearing electrodes that connect to a small device you can attach to a belt. This monitors your heart over the course of 24 hours.

Find out more about how doctors diagnose heart failure.

What are the complications of a right bundle branch block?

If you do not have significant heart disease, there may not be any complications of a right bundle branch block (RBBB).

However, RBBB may increase your risk of loss of life if you have heart disease or heart failure. Following any treatment plan your doctor recommends can help reduce this risk.

Contact your doctor if you have concerns about RBBB.

What is the life expectancy for somebody with a right bundle branch block?

A right bundle branch block (RBBB) may not affect your life expectancy. It is generally a benign ECG finding for which you may not require any treatment.

However, RBBB may occur alongside cardiovascular disease. Cardiovascular disease can affect your life expectancy, so it is important to follow any treatment plan for RBBB your doctor recommends.

Staying on top of your heart health can help prevent or reduce the risk of heart conditions and complications.

You should aim to have a medical professional check your blood pressure at least once per year if you have low blood pressure. Your doctor may wish to monitor your blood pressure more regularly if you have high blood pressure.

What is the difference between a right vs. left bundle branch block?

A right bundle branch block (RBBB) is a common ECG finding that occurs when there is damage or stretching to the right bundle branch. This can prevent pulses from properly traveling through.

A left bundle branch block (LBBB) is also a common ECG finding. It occurs when there is damage or stretching to the left bundle branch.

Similar to RBBB, LBBB can occur in otherwise healthy individuals. However, it can often indicate significant heart disease.

Summary

A right bundle branch block (RBBB) is a frequent ECG finding that may indicate damage or stretching to the right bundle branch. It is often a benign finding. However, in some cases, it can be a sign of heart failure or cardiovascular disease.

You will not usually experience any symptoms of RBBB. In turn, you may not require any treatment. If you do experience symptoms alongside RBBB, your doctor may arrange for further tests to monitor your heart health and identify underlying conditions.

Contact your doctor if you have concerns about your heart health. They will be able to carry out tests, including an ECG. If RBBB is present, they will be able to advise on whether or not they recommend any further tests or treatment.

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Medical Reviewer: Uzochukwu Ibe, MD, MPH
Last Review Date: 2022 Aug 16
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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