What are the types 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

Three types of right bundle branch block have been identified in electrophysiologic studies. Proximal, or central, right bundle branch block occurs when a conduction block is present just distal to the bundle of His in the superior aspect of the right bundle branch. This generally occurs when the proximal bundle is injured during surgery for lesions with an inlet or membranous ventricular septal defect (VSD).

Another type of right bundle branch block occurs when the impulse is interrupted between the proximal and distal aspects of the right bundle branch; this type is most commonly observed after surgical division of the moderator band during repair of tetralogy of Fallot.

Distal right bundle branch block is observed when distal ramifications of the right bundle are disrupted during right ventriculotomy or resection of muscle bundles in the right ventricular outflow tract. Regardless of the type of right bundle branch block, the ECG patterns remain similar.


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