Right Bundle Branch Block

Conduction

Recognition

  • QRS ≥120 ms
  • RSR' (M-shape) in V1–V2
  • Slurred S in I, V5–V6
  • T-wave inversion V1–V3

Key findings

  • Right axis if old MI / cor pulmonale

Clinical importance

  • May be benign in young
  • Acute new RBBB: think PE, MI

Management pearls

  • Investigate cause if new
  • No treatment if isolated and asymptomatic
WardRound

WardRound

Clinical Decisions in Seconds