Right Bundle Branch Block

What is right bundle branch block?

Right bundle branch block is an obstacle in your right bundle branch that makes your heartbeat signal late and out of sync with the left bundle branch, creating an irregular heartbeat.

Electrical signals in your heart act like a pacemaker that controls your heartbeats. This signal starts in the sinoatrial (SA) node, which tells your left and right atria (upper heart chambers) to contract. Next, the signal goes to your atrioventricular (AV) node and bundle branches, which make your left and right ventricles tighten.

Normally, the signal goes down both bundle branches at once and both ventricles are working at the same time. When the signal goes down the right bundle branch a little slower than the left bundle branch, the right ventricle contracts later than the left one. This is what’s going on when you have a right bundle branch block, and it happens because the signal has to go around a block in the branch.

Because the ventricles aren’t working at exactly the same time, this creates an irregular heartbeat (arrhythmia.)

Right bundle branch block can be complete or incomplete. Unlike complete right bundle branch block, incomplete right bundle branch block doesn’t increase your risk of heart attack and death.

Who does right bundle branch block affect?

Right bundle branch block can happen in healthy people. It’s more likely to happen in older people.

What are the symptoms of right bundle branch block?

You most likely won’t have any symptoms.

What causes right bundle branch block?

There are several causes of right bundle branch block, including:

• Myocarditis.
• Trauma to your chest.
• Heart attack (myocardial infarction).
• Right heart catheterization or other procedures.
• Changes in branch structure, such as stretching.
• Diseases (like Lev’s disease or Lenegre’s disease).

How is right bundle branch block diagnosed?

A provider often finds it during an annual physical.

What tests will be done to diagnose right bundle branch block?

Your healthcare provider will review your electrocardiogram (EKG) results carefully to make sure you don’t have a different problem, such as:

• Ventricular tachycardia.
• Brugada syndrome.
• Incomplete left bundle branch block.

How is right bundle branch block treated?

Usually, if you don’t have symptoms and you don’t have heart disease, you don’t need treatment for right bundle branch block.

What can I expect if I have right bundle branch block?

Right bundle branch block may stay the same without any change or the block may progress to involve other conduction branches.

How long does right bundle branch block last?

Right bundle branch block doesn’t go away.

What is the outlook for right bundle branch block?

Your outlook depends on whether you have cardiovascular disease. If you don’t have heart disease, having right bundle branch block doesn’t change your life expectancy or add to your risk level. But having right bundle branch block can put you at a higher risk of death if you also have heart failure or a heart attack.

How do I take care of myself with right bundle branch block?

If you don’t have symptoms and you don’t have heart disease, you don’t need to do anything for right bundle branch block. But if you’ve had other problems like a heart attack or heart failure, you need to continue with treatment for those issues.

When should I see my healthcare provider?

You should see your provider if you have other heart problems in addition to right bundle branch block.

When should I go to the ER?

You should go to the ER if you think you’re having a heart attack.

What questions should I ask my doctor?

• What caused my right bundle branch block?
• What can I do to keep my heart failure from getting worse?
• How can I take care of myself after a heart attack?

How common is a right bundle branch block?

Many people have right bundle branch block, especially as they age. About 11% of people have this by the time they’re 80.

How serious is a right bundle branch block?

If you have no symptoms and no heart disease, a right bundle branch block is not serious. But if you’ve already had heart failure or a heart attack along with right bundle branch block, it puts you at a higher risk of death.

Is right bundle branch block permanent?

Yes.

A note from Cleveland Clinic

Right bundle branch block isn’t a cause for worry if you don’t have symptoms or heart disease. But when you have right bundle branch block and you’ve already had a heart attack or heart failure, you should focus on continuing with treatment for those problems. Be sure to follow your provider’s treatment plan for the best results.