What is the morbidity and mortality associated with 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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Surgically induced right bundle branch block is generally considered to have in no clinically significant acute hemodynamic consequences and has a benign course over the long term. However, the role of right bundle branch block in acute right ventricular dysfunction following tetralogy of Fallot repair is unknown since this is a routine postoperative finding. Patients who have undergone tetralogy of Fallot repair and have a QRS duration more than 180 milliseconds may have a long-term risk of ventricular arrhythmias and sudden death. In rare cases, if right bundle branch block is associated with injury to the proximal His-Purkinje system (eg, left anterior hemiblock, first-degree atrioventricular [AV] block), it can progress to complete heart block and sudden death.

Patients with familial right bundle branch block may have a benign course, whereas those with right bundle branch block in association with Brugada syndrome, arrhythmogenic right ventricular cardiomyopathy (ARVC), or Kearns-Sayre syndrome are at risk for sudden death.

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