Right Bundle Branch Blocks (RBBB)

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Right bundle branch blocks are caused by a delay in depolarization of the right ventricle. In this case the left ventricle is responsible for conducting the electrical impulse to the right ventricle. In the event of a right bundle branch block, three waves of depolarization occur. Conduction is not affected to the left, therefore the normal waveforms are seen in leads V1 and V6. There is, however, an additional wave associated with right bundle branch blocks.

Lead V1 - rSR' & R' are the result of the third wave of depolarization traveling back toward lead V1 to depolarize the right ventricle. If the complex is greater than 0.10 seconds, it represents an incomplete right bundle branch block. If the complex is greater than 0.12 seconds, it represents a complete right bundle branch block.

Lead V6 - qRS & S are the result of the third wave of depolarization traveling away from lead V6, producing a negative deflection. If the complex is greater than 0.10 seconds, it represents an incomplete right bundle branch block. If the complex is greater than 0.12 seconds, it represents a complete right bundle branch block.


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