right bundle branch block (RBBB)
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Introduction
- an ECG change characterized by an intraventricular conduction delay affecting the right ventricular wall. Acute occurrences
- most commonly result from myocardial ischemia.
Etiology
- myocardial ischemia (most common)
- hypertension
- rheumatic heart disease
- can be found in normal individuals
Diagnostic procedures
- electrocardiogram
- prolonged QRS
- triphasic complexes (bifid QRS)
- lead V1: rsR'
- lead V6: qRs (MKSAP20 disagrees, no q-wave)
- wide terminal S waves in leads I & lead V6
*RBBB tends to decrease voltage, thus can identify LVH.
*The initial septal activation is from the left to right & anteriorly.
Right ventricular activation occurs following completion of the left ventricular activation.
Delayed activation of the right ventricle is responsible for the rsR' pattern in V1 & the round deep S wave in V6.