CVS » Conduction disturbances

Bundle branch blocks in the ECG

RBBB is commonly seen without serious heart disease. Clinical significance depends on the possible underlying disease, which may be myocardial infarction, myocarditis, pulmonary embolism, COPD (cor pulmonale).Often it may be a sequel of congenital heart disease that remains even after corrective surgery (ASD). LBBB is frequently a sign of heart disease. LBBB at middle age usually reflects acquired heart disease, most commonly LVH, coronary heart disease or myocarditis. In connection with acute myocardial infarction (AMI), recent LBBB predicts extensive myocardial damage and poor prognosis. LAHB is the most common intraventricular block. The left anterior branch is easily damaged and a block does not mean that the damage to the heart is considerable. LPHB (LPFB), left posterior hemiblock is extremely rare. In bifascicular block, RBBB+LAHB, in asymptomatic patients the prognosis is frequently good. In myocardial diseases the condition may progress to a trifascicular block. In Trifascicular blocks (RBBB+LAHB+AV block), the risk of total AV block is high, which is why pacemaker is often necessary. The prognosis is rather poor even with a pacemaker.

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