| 词条 | Right bundle branch block |
| 释义 |
| name = Right bundle branch block | synonyms = | image = Right bundle branch block ECG characteristics.png | caption = ECG characteristics of a typical RBBB showing wide QRS complexes with a terminal R wave in lead V1 and a prolonged S wave in lead V6. | pronounce = | field = Cardiology | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} A right bundle branch block (RBBB) is a heart block in the right bundle branch of the electrical conduction system.[1] During a right bundle branch block, the right ventricle is not directly activated by impulses travelling through the right bundle branch. The left ventricle however, is still normally activated by the left bundle branch. These impulses are then able to travel through the myocardium of the left ventricle to the right ventricle and depolarize the right ventricle this way. As conduction through the myocardium is slower than conduction through the Bundle of His-Purkinje fibres, the QRS complex is seen to be widened. The QRS complex often shows an extra deflection that reflects the rapid depolarisation of the left ventricle followed by the slower depolarisation of the right ventricle. It is seen in healthy individuals in about 1.5-3%.[2] CausesCommon causes are Normal variant, Right ventricular hypertrophy or strain, Congenital heart disease such as atrial septal defect and Ischemic heart disease. [3] In addition, a right bundle branch block may also result from Brugada syndrome, pulmonary embolism, rheumatic heart disease, myocarditis, cardiomyopathy, or hypertension. Diagnosis{{multiple image| direction = horizontal | width = 155 | footer = | image1 = Reizleitungssystem 12.png | alt1 = | caption1 = Normal electrical conduction system of the heart (Schematic). All myocardial segments are excited almost simultaneously (purple staining). {{ordered list |Sinoatrial node |Atrioventricular node}} | image2 = Reizleitungssystem RSB.png | alt2 = | caption2 = Conduction in RBBB (Schematic): With a blockage in the right bundle branch (red), the left ventricle is excited in time (purple), while the excitation of the right ventricle takes a detour via the left bundle branch (blue arrows). }} The criteria to diagnose a right bundle branch block on the electrocardiogram:
The T wave should be deflected opposite the terminal deflection of the QRS complex. This is known as appropriate T wave discordance with bundle branch block. A concordant T wave may suggest ischemia or myocardial infarction. TreatmentThe underlying condition may be treated by medications to control hypertension or diabetes, if they are the primary underlying cause. If coronary arteries are blocked, an invasive coronary angioplasty may relieve the impending RBBB.[5] EpidemiologyPrevalence of RBBB increases with age. See also
References1. ^{{cite web |url=http://courses.kcumb.edu/physio/blocks/index.htm |title=Conduction Blocks 2006 KCUMB |work= |accessdate=2009-01-20}} 2. ^{{cite journal|pmc=1122450 | pmid=11872557 | volume=324 | issue=7336 | title=Bradycardias and atrioventricular conduction block |date=March 2002 |vauthors=Da Costa D, Brady WJ, Edhouse J | journal=BMJ | pages=535–8 | doi=10.1136/bmj.324.7336.535}} 3. ^{{cite book|last=Goldman|first=Lee|title=Goldman's Cecil Medicine|publisher=Elsevier Saunders|location=Philadelphia|year=2011|isbn=1437727883|pages=400–401|edition=24th}} 4. ^{{cite web |url=http://library.med.utah.edu/kw/ecg/ecg_outline/Lesson6/index.html#RBBB |title=Lesson VI - ECG Conduction Abnormalities |work= |accessdate=2009-01-07}} 5. ^{{Cite web|title = Right Bundle Branch Block|url = https://www.symptoma.com/en/info/right-bundle-branch-block|website = www.symptoma.com|accessdate = 2015-08-13}} External links{{Medical resources| DiseasesDB = 11620 | ICD10 = {{ICD10|I|45|1|i|30}} | ICD9 = {{ICD9|426.4}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = ped | eMedicineTopic = 2500 | MeshID = }}{{Circulatory system pathology}}Bloc de branche#Bloc de branche droit 1 : Cardiac arrhythmia |
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