What is the prognosis 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

The prognosis for patients with isolated right bundle branch block is excellent because the course of right bundle branch block is generally benign.

In other patients with right bundle branch block, such as those who have undergone heart transplantation or repair of congenital heart disease and those with Brugada syndrome, Kearns-Sayre syndrome, myocarditis, or cardiomyopathy, the prognosis depends on the underlying condition causing the right bundle branch block and the morphology of the systemic ventricle.

In pediatric patients after ventricular septal defect (VSD) patch closure or tetralogy of Fallot repair, the presence of the right bundle branch block has been shown to cause some mechanical dyssynchrony and a tendency toward left ventricular dilatation. Therefore, long-term follow-up of these patients has been suggested. [12, 13]

In a more recent study, investigators found that acute right ventricular resynchronization led to short-term improvement of hemodynamics in children early after repair of tetralogy of Fallot, and the effect was maximized when paced from the site of the latest right ventricular activation. [14] The researchers suggested right ventricular resynchronization has the potential to be a useful nonpharmacologic adjunct in the management of hemodynamically compromised children.


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