Right Bundle Branch Block RBBB

If the QRS complex is positively deflected in lead Vi, wider than 2.5 snudl sqnares and cannot be explained by any of the other causes of widened. 

QRS then it is a RBBB (Figs. 7.4 and 7.5). The incidence of RBBB increases with age and does not normally require treatment. 

Ischemic Heart Disease (IHD) Myocardial Infarction (MI) Normal variant Cardiomyopathy Fibrosis of condnction system Hypertension Pnlmonary Embolism Atrial Septal Defect (ASD) Congenital heart disease 

Qnick way to tell right and left Bnndle Branch Block apart. Widened QRS, look in lead Vi Canses 

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Left bundle branch block (LBBB) is characteristic of poisoning and is defined by Zimetbaum et al. (2004) as QRS > 0.12 s with delayed intrinsicoid deflection in the Vi, V5, and Vs leads greater than 0.05 s. The risk of arrhythmia is greatest when QRS is >0.11 s. Right bundle branch block (RBBB) greater than 0.12 s is a fairly good predictor of arrhythmic death. 

Refers to a block in the electrical impulse down one of the bundle branches, knovm either as a left or right Bundle Branch Block (LBBB/RBBB). The principle characteristic of a Bundle Branch Block is a widened QRS complex. This occurs because the impulse cannot travel down the fast conduction pathway due to the blockage (Fig. 7.1). The impulse takes an alternative route through the myocardium resulting in delayed ventricular depolarisation and the characteristic widened QRS complex (Fig. 7.2). A normal QRS complex has a width of 0.06-0.10 s (1.5-2.5 small... 

Posterior/inferior (leads II, III, AVF) Summarize Q/ST itmes for use in PREDICT point computation Q/ST Score Add scores to got Q/ST score (enter 0-15) — Circle any bundle branch block (BBB) for use in PREDICT point Computation Right BBB MN code 7.2.1 RBBB Left BBB MN code 7.1.1 LBBB Intraventricular MN code 7.4 IVB PREDICT point computation 1 ... 

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