What is the pathophysiology of pediatric right bundle branch block?

Updated: Jul 26, 2018
  • Author: Glenn T Wetzel, MD, PhD; Chief Editor: Syamasundar Rao Patnana, MD  more...
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Answer

Knowledge of the anatomy and electrophysiology of cardiac conduction system from the atrioventricular (AV) junction to the Purkinje fibers is essential to understanding the pathophysiology of right bundle branch block.

Right bundle branch block occurs when the electrical impulse from the bundle of His does not conduct along the right bundle branch. Conduction down the left bundle branch proceeds normally, and the interventricular septum and left ventricle rapidly depolarize in the normal fashion. Depolarization of the right ventricle occurs later and is comparatively slow, accounting for the electrocardiographic (ECG) findings in right bundle branch block (see the images below).

These electrocardiographs demonstrate a normal sin These electrocardiographs demonstrate a normal sinus rhythm and a sinus rhythm with a right bundle branch block.
This image depicts the electrophysiologic events o This image depicts the electrophysiologic events of right bundle branch block. AV = atrioventricular.
Pathophysiology of right bundle branch block is de Pathophysiology of right bundle branch block is described. AV = atrioventricular; LV = left ventricular; RV = right ventricular.

Exercise-induced right bundle branch block has been rarely noted and appears to be benign. [1]


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