Angina

Left bundle branch block ecg. Right heart branch block treatment

Is there a cure for bundle branch block?
Prevention of heart disease

Right bundle branch block is a pathology that interferes with the normal passage of the sinus impulse of the conduction system of the heart. As you know, the heart muscle consists of atria and ventricles. Under the influence of natural processes, contraction occurs, which provides the body with normal blood circulation.

Electrical impulses generated in this system ensure normal functioning of the heart. Between the atria and ventricles is the so-called atrioventricular node. The impulse, passing through the sinus node, reaches the atrioventricular node, lingers there for seconds and is sent through the bundles of His. The bundles of His are muscle fibers. The two parts of these bundles are called “legs”: left and right.

In a healthy person, impulses travel through both legs. Block of the bundle branches occurs when excitation along one of the legs occurs more slowly. In this case, conduction disturbance occurs in the cardiac system. Such changes can be a signal of a serious illness or the norm. To establish a diagnosis, it is necessary to undergo an examination. In some cases, such disorders may indicate pulmonary pathologies.

For what reasons does blockade occur?

Right bundle branch block occurs in both young and elderly people. According to statistics, this disorder is more common in men. 30% of young patients do not have any cardiac pathologies due to disorders of the conduction system of the heart.

The anatomical structure of the branches of the His bundle is such that blockades can be single-bundle, double-bundle and three-bundle. The reasons for this phenomenon are different. The further prognosis will depend on these reasons. The factors that cause this pathology are:

coronary heart disease (CHD);
congenital heart defects;
myocardial infarction;
sternum injury;
cardiomyopathy (damage to the heart muscle);
hyperkalemia (excess potassium in the blood);
overdose of cardiac medications;
progressive muscular dystrophy;
syphilis;
heart surgery;
right ventricular distension;
smoking;
alcohol abuse;
autonomic disorders in neurosis;
hormonal disorders;
hypoxia in diseases of the respiratory system.

Also, right bundle branch block can develop due to tricuspid valve insufficiency. Such a disorder may be congenital and considered a variant of the norm that does not require treatment. Heart block may be functional. This means that it can occur under certain loads and go away on its own, but this does not pose any danger. The reasons listed are acquired.

But defects that provoke blockades can also be congenital. For example, children whose mothers had diabetes during pregnancy may have congenital Lenegre disease (conduction disorders). Heart defects of various etiologies, anomalies of the atrial septum, and pulmonary stenosis are also congenital factors that can cause damage to the heart muscle.

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What symptoms accompany the pathology?

How can you suspect this disorder? If the blockade of the right bundle branch is incomplete and isolated, then there will be no pronounced symptoms. It can only be detected by examination using an ECG. But since such a pathology can be a “companion” of other cardiac pathologies, symptoms may be present in the form of changes in heart sounds when listening.

For example, during auscultation (listening), a splitting of the second tone is heard and its intensification during inhalation, because the closing of the valve leaflets slows down.

In addition to this symptom, the following may be observed:

Bundle branch block can be complete or partial (incomplete), persistent or transient. Even with complete blockade, there may be no symptoms unless there is serious heart disease. Such abnormalities can only be detected with an ECG. Sometimes disorders in the cardiac system are associated with the fact that a person suffered from a number of infectious diseases in childhood, such as tonsillitis, measles, influenza, scarlet fever. By the time it is detected, treatment is no longer required.

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How to get tested for heart block?

If you have complaints about your heart, you should visit a cardiologist. If you have pain in the heart area, extrasystole (irregular heart rhythm), shortness of breath, or fatigue, you should consult a doctor. Although such symptoms may be a sign of other diseases not related to the heart, this will only be known after examination. To make a diagnosis you need to do:

electrocardiogram;
daily ECG monitoring.

An electrocardiogram is a procedure that records a curve reflecting the activity of the heart muscle. This diagnosis is the simplest and most accessible in a regular clinic. Thanks to the ECG, you can see how much electrical impulses are blocked.

Ultrasound (ultrasound examination) allows you to see the work of the heart in real time. This diagnostic method is also available nowadays. Daily monitoring (Holter) helps determine the work of the heart during the day. A special device is attached to the patient’s body and records any disturbances both during night sleep and during physical activity during the day. Thanks to this study, it is possible to determine whether the blockade is passing. A diary is kept in which the patient writes down all his complaints.

Bundle branch block is a hindrance or obstacle to the normal passage of the sinus impulse through the cardiac conduction system. Such an impulse is formed in the sinus node, goes beyond its boundaries, enters the atrium system and excites both atria as it passes. During its passage, the sinus impulse undergoes a considerable physiological delay, reaching the atrioventricular junction and entering the small conduction system of the ventricles.

Features of the disease

Blockade of the left or right bundle branches is a dangerous disease associated with the heart, which is necessary for the normal functioning of the heart.

Very rarely, the disease is diagnosed in young people and the general figures range from about 0.1% of known cases.
The older the person, the more often this disorder is diagnosed.
At age 40, the percentage is already 4.5%.

Most often the disease occurs in men. And quite often it is provoked by an anterior transmural infarction. In the case of a posterior infarction, a partial blockade of the right/left bundle branch is determined.

ICD-10 codes:

Intraatrial blocks:
- I45.8 Other specified conductivity faults.
Intraventricular blocks:
- I44.4 Block of the branch of the (anterior) left bundle branch.
- I44.5 Block of the branch of the (posterior) left leg.
- I44.7 Left leg block, unspecified.
- I45.0 Right leg block.
- I45.2 Double bundle block.
- I45.3 Trifascicular block.

Types and forms

According to the anatomical structure of the blockade

According to the anatomical structure of the His bundle block, they are divided into:

single-beam;
two-beam;
three-beam.

Single-bundle blockades - damage to only one leg: blockade of the right leg, left anterior leg and left posterior leg. Double-bundle blockade - when 2 branches of the His bundle are affected simultaneously (branches of the posterior and anterior left legs, right legs and left anterior branches, branches of the posterior left and right legs). Three-bundle blocks - damage to all three branches of the His bundle.

According to the degree of impulse conduction disturbances

Blockades of the legs of His are also divided according to the degree of impulse conduction disturbances:

incomplete;
full.

Incomplete blockade is a violation of the passage of impulses along one branch of the His bundle. In this case, the function of the second leg or branch is not impaired. Excitation of the ventricular myocardium occurs more slowly than it should and is provided by healthy branches.

When the impulse passes through the branches at a slow rate, it is called incomplete 1st degree heart block.
In the case when only some impulses reach the ventricles, heart block of the 2nd degree (incomplete) occurs.
3rd degree block or complete block is defined as the complete inability of cardiac impulses to pass into the ventricles. Because of this, the latter contract independently, at a speed of 20 to 40 beats per minute.

Even more useful information on the issue of incomplete bundle branch block is contained in the following video:

By duration

Leg blocks are:

transient (intermittent);
permanent (irreversible).

In rare cases, disturbances in the transmission of impulses begin to develop with changes in heart rate. For example, when or .

Causes

Provoking factors for His bundle conduction disorders include:

previous ;
hypertension;
chronic respiratory diseases with obstruction;
blunt chest trauma;
neoplasms on the heart;
progressive muscular dystrophy;
overdose of certain medications;
myocardial pathology;
high potassium levels in the blood.

Hereditary factors:

defective development of the segment of the right bundle branch;
, leading to increased load on the right ventricle.

Symptoms

Incomplete isolated blockades of the right and left bundle branches have little effect. It may be detected incidentally using an ECG. Clinical symptoms of the disease can manifest themselves only with complete blockade of the right leg. In a third of patients, signs of disturbances may be observed during routine cardiac auscultation.

Possible symptoms include:

dizziness, lightheadedness, fainting;
fatigue, weakness;
shortness of breath and lack of air.

Diagnostics

The diagnosis is made based on the patient’s complaints, examination and listening to the heart. An ultrasound of the heart and an ECG are required to identify complete or incomplete blockade of the left or right bundle branch. The examination does not make it difficult to establish a diagnosis; such disorders are revealed by a comprehensive examination of the patient.

Read on to learn more about treatment methods for complete or incomplete blockade of the right/left bundle branch.

The following video will tell you more about how an ECG occurs in the case of right/left bundle branch block:

Treatment

Blockage of the left (right) leg usually does not imply any treatment. The emphasis is on the disease that provokes such disorders.

Medication

Prescribe vitamin and restorative medications, a diet excluding sugar and fats. The emphasis in food is on eating fresh vegetables and fruits.

In the event that cardiac conduction disturbance is complicated by angina pectoris, heart failure, arterial hypertension, therapy is carried out using:

nitrates;
cardiac glycosides;
antihypertensive drugs.

Surgical

It is produced in the ineffectiveness of drug therapy and with frequent fainting, as well as in malignant processes.

In case of AV blockade, indications for pacemaker implantation can be considered. In case of His bundle block, which occurs without obvious clinical manifestations, dynamic observation is carried out.

Prevention

Preventive measures include:

daily routine, full and restful sleep;
refusal of fried, canned and spicy foods;
consumption of foods with a significant fiber content: fresh fruits and vegetables, herbs;
avoidance of stressful situations;
taking medications only prescribed by a doctor and under his supervision;
timely diagnosis and treatment of diseases of all organs, not just the heart;
mandatory consultation with a doctor if symptoms of the disease appear.

Read on to learn about the consequences of complete and incomplete blockade of the right/left bundle branch.

Complications

The main consequences of the disease include:

All parents whose children have undergone right/left bundle branch block and other concomitant diseases should watch the following video:

Nowadays, you will not meet a person who could say that he is absolutely healthy. Constant stress and poor lifestyle take their toll. Our heart is subjected to constant stress and wears out, which subsequently leads to malfunctions in its functioning.

Many people do not want to go to the hospital because they are afraid to hear that there are problems with their health. But heart disease is not something to joke about. Only thanks to modern diagnostic and treatment methods can you prolong your life.

If you did not have any symptoms of heart disease, but after undergoing an examination you were diagnosed with right bundle branch block, do not rush to panic. It’s worth asking your doctor everything and undergoing additional diagnostics. Sometimes, no special treatment is required. In this article, we will consider what kind of pathology this is, its type, causes, characteristic symptoms, how it manifests itself on an ECG and treatment methods.

Right bundle branch block

The bundle of His lies below the atrioventricular node (atriventricular node), but there is no clear boundary between them. Its length is about 2 cm, but this figure may be different, depending on the individual characteristics of the person.

The constituent segments of the His bundle are:

Penetrating or initial. This is part of the bundle of His, characterized in that it does not contact the myocardium. And also its peculiarity is that this segment is not sensitive to disturbances in the functioning of the coronary arteries.

But if pathologies develop in the fibrous tissue that surrounds the bundle, then the penetrating part quickly becomes inflamed.

Branching or membranous. This part of the bundle is located in the interventricular septum. First it enters the membranous part of the septum, and then passes into the myocardium.

In the initial segment there are cells that are located in the lower part of the atrioventricular node and have the function of cardiac automatism. It is these cells that produce about 40-60 impulses per minute. The automatism of the beam is called second-order automatism. The bundle of His is divided into right and left bundles.

The left one is shorter, but it branches into 2 more parts. The trunk of the His bundle is located above the interventricular septum, and the right and left branches diverge, respectively, into the RV and LV. The stalks then branch into small Purkinje fibers in the cardiac muscle.

It should be noted that the main function of these structures is to conduct impulses from the right atrium, or more precisely, from the sinus node, to the ventricles. As a result, the ventricles contract with the same frequency and force as the atria.

Right bundle branch block - general characteristics

The human heart consists of muscles that have autonomy and conductivity. Myocardial tissue can create and conduct excitation. The fact that the human heart contracts and supplies blood to the entire human body is possible only thanks to the work of myocardial fibers.

A small collection of cells in the conduction system of the heart, only about 2 cm in size, is called the bundle of His. It is also called the atrioventricular bundle. It includes the right and left legs and is located near the interventricular septum and two nodes:

atrioventricular;
atrioventricular.

To fully understand the intricacies of this disease, you need to imagine how the human heart works. The ability of the heart to generate rhythms is possible only due to the presence of pacemaker cells specialized for this (in other words, pacemakers). These include:

sinoatrial;
sinoatrial nodes, which are located in the right atrium.

The rhythm is transmitted from them to the atria, and from there to the His bundle to the ventricles. Interruptions in the transmission of the His bundle are directly related to disruption of the rhythm. And if the rhythm is disturbed, it means that the heart is not working correctly, which can lead to disastrous consequences. Depending on whether the blockade has occurred - complete or incomplete - there are different consequences.

With incomplete blockade, the deviation is partial, and with complete blockade, the end of impulse conduction occurs. As world medical practice shows, this defect is most often found in older people, and, as studies show, most often in the male half of the population. Younger people are much less susceptible to this phenomenon. The risk of the disease increases with age.

coronary heart disease (CHD);
congenital heart defects;
myocardial infarction;
sternum injury;
cardiomyopathy (damage to the heart muscle);
hyperkalemia (excess potassium in the blood);
overdose of cardiac medications;
progressive muscular dystrophy;
syphilis;
heart surgery;
right ventricular distension;
smoking;
alcohol abuse;
autonomic disorders in neurosis;
hormonal disorders;
hypoxia in diseases of the respiratory system.

Also, right bundle branch block can develop due to right ventricular hypertrophy, mitral stenosis, and tricuspid valve insufficiency. Such a disorder may be congenital and considered a variant of the norm that does not require treatment.

Heart block may be functional. This means that it can occur under certain loads and go away on its own, but this does not pose any danger. The reasons listed are acquired.

Symptoms

For example, during auscultation (listening), a splitting of the second tone is heard and its intensification during inhalation, because the closing of the valve leaflets slows down.

In addition to this symptom, the following may be observed:

dizziness;
fainting;
dyspnea;
feeling of lack of air;
weakness;
fatigue;
decreased performance;
panic attacks.

Sometimes disorders in the cardiac system are associated with the fact that a person suffered from a number of infectious diseases in childhood, such as tonsillitis, measles, influenza, scarlet fever. By the time it is detected, treatment is no longer required.

BNPG is classified according to various criteria. If we consider it from the position of impulse conduction, then it is incomplete when the impulse slows down, but still passes. Complete blockade is the absolute cessation of impulse transmission.

Separation by the number of non-conductive beams:

Single-fascicle - the right leg is most often affected, but conduction may disappear only in the left or only in the back.
Double-fascicle – covers the branch of the left; one left branch and one right leg.
Three-bundle – there is incomplete or complete blockade of the right and left legs.

Classification by types of development:

Intermittent - during the cardiogram it appears and then disappears.
Constant – can be traced during the study constantly.
Transient - blockade of the right bundle branch appears on the ECG from time to time.
Alternating. This form is characterized by manifestations of blockade either on the right or on the left leg.

Stages of ventricular excitation during PNPG blockade

The process of ventricular excitation during PNPG block can be divided into three stages:

Normal depolarization of the interventricular septum.
Normal LV depolarization.
Delayed excitation of the pancreas.

The stages of ventricular excitation during PNPG block are represented on the electrocardiogram by biphasic complexes in the precordial leads:

in lead V1 – rSR’ complex with a wide R’ wave;
in lead V6 – qRS complex with a wide S wave.

The first stage of ventricular depolarization is normally excitation of the interventricular septum. First, the left part of the septum is excited along the LBP. Normally, the electrocardiogram shows a small septal r wave in lead V1 and a small q wave in lead V6.

It is clear that blockade of PNPG should not affect the septal stage of ventricular excitation, since its stimulation depends on LBP. The second stage of ventricular excitation is simultaneous depolarization of the LV and RV. RBBB block should also not affect this stage, since the LV is usually electrically dominant over the right, causing deep S waves in the right precordial leads and tall R waves in the left precordial leads.

Changes in the QRS complex during PNPG block are a consequence of prolongation of the time required for excitation of the RV. This means that after complete depolarization of the LV, depolarization of the RV continues.

Delayed RV depolarization is the third stage of ventricular excitation. Electrical potentials at this stage are directed to the right and reflect the slow propagation of the depolarization wave through the RV. For this reason, in the right precordial leads (for example, in lead V1), this stage of ventricular excitation appears electrocardiographically as a positive, wide R wave.

Slow rightward propagation of delayed RV depolarization potentials produces a broad negative S wave in the left precordial leads (eg, lead V6). If you understand the mechanism of these stages, you can imagine a chest lead electrocardiogram during PNPG block.

Lead V1 is characterized by an rSR' complex with a wide R' wave. In lead V6, a QRS complex with a wide S wave is recorded. A tall, wide R wave in the right precordial leads and a deep S wave in the left leads also reflect the slow propagation of delayed depolarization potentials through the RV.

To suggest the presence of RBBB block, it is necessary to evaluate leads V1 and V6. Typical QRS complexes in these leads simplify the diagnosis.

In some patients, incomplete blockade of the right bundle branch is a feature of their physiology. However, in this case, you should not refuse a full examination of the heart. A thorough diagnosis will allow you to establish the exact cause of the blockade and eliminate the development of unwanted complications.

This pathology can develop against the background of the following conditions:

ischemic necrosis of the myocardium;
neoplasms in the heart muscle;
persistent high blood pressure;
replacement of heart muscle cells with scar tissue;
disturbance of protein metabolism in cardiac tissues;
heart valve defects;
severe form of hypothyroidism;
excess potassium in the body;
against the background of drug treatment;
chest injuries.

In case of incomplete blockade of the right leg, the complete absence of excitation is not recorded. It is observed, but the process is rather slow. In some cases, incomplete RBBB is recorded with an increase in the middle muscle layer of the pancreas and is a manifestation of this particular pathology, and not a consequence of a violation of general conductivity.

It is quite difficult to detect incomplete RBBB on an ECG. This pathology can greatly distort the results of the cardiogram. In addition, this condition may be temporary and changeable. Signs of blockade appear and disappear; accordingly, the electrocardiogram can record deviations that are replaced by normal values. These are so-called transient blockades.

They most often occur against the background of damage to the tissues of an organ or conduction system under the influence of stress factors, metabolic disorders or secondary cardiac disease. With a transient blockade, the QRS complexes, which are recorded when the stomachs of the “blocked” leg are excited, periodically alternate with normal QRS complexes.

Complete blockade

Complete blockade of the right bundle branch is usually manifested by Wilson's block and indicates a clear disruption of the process of propagation of automatic rhythmic self-excitation through the muscular structures of the ventricles and is not so rare.

This blockade is characterized by the fact that the RV contracts not through the transmission of nerve impulses emanating from the right leg, but due to those spreading from the LV. However, similar ECG results can also give independent enlargement or other pathologies of the pancreas.

The main signs of the pathological condition:

disturbance of pulse waves;
rapid and difficult breathing even with minimal exertion;
“illusion of movement” in the head;
state close to fainting;
loss of consciousness;
increased fatigue;
drowsiness;
loss of strength;
depression.

Complete blockade of PNPG on the ECG can be observed in the following conditions:

angina pectoris, heart attack, atherosclerotic cardiosclerosis;
inflammation of the heart muscle or enlargement of the pancreas;
pathological anastomosis between the right and left atrium;
enlargement and expansion of the right side of the heart;
myocardial dystrophy against the background of endocrine and autoimmune disorders.

Pathology can also be provoked by concomitant diseases that cause enlargement and strain on the heart chambers on the right. As a rule, these are various pulmonary pathological processes: bronchial asthma, emphysema, pulmonary embolism, prolonged pneumonia, chronic bronchitis.

Rarely, RBBB can be the result of strong emotional stress or fear, even in healthy people.

When diagnosing this pathology, a full-fledged ECG report indicates the nature of heart contractions, the total magnitude of bioelectrical changes occurring in the heart muscle with each contraction, characterizes the blockade, and also mentions the prolongation of the QT interval. However, to confirm the diagnosis, a cardiogram alone is often not enough, so additional diagnostic methods are resorted to.

In children, this pathology can appear in fetal development, at the time of heart formation. Or after birth as a result of previous diseases of the cardiovascular system. The signs of this disease will be as follows:

poor blood supply and lack of oxygen will lead to cardiac ischemia;
death of the His bundle due to oxygen starvation will lead to myocardial infarction, scar tissue will form;
as a result of heart failure;
diseases resulting from myocardial damage; underdevelopment of the heart during the prenatal period;
inflammatory processes in the heart muscle; surgical intervention;
in the presence of an autoimmune disease, disturbances in the functioning of the heart may occur;
an increase in blood pressure, as a result of which, under high loads, changes in the structure and function of the heart can occur.

Congenital blockade in children can occur as a result of:

diffuse damage to the connective tissue of the expectant mother;
if the expectant mother suffers from diabetes mellitus (insulin dependent);
underdevelopment of the right bundle branch;
pathological development of cardiac septa.

This pathology can be a consequence of heart injury. This can happen as a result of incorrectly performed surgical operations, as a result of a blow to the chest during a fall or push, or in a traffic accident.

If there is an incomplete block of the bundle branches, then no special treatment is required. The only thing that needs to be done is to prevent the transition to more severe forms. Do not ignore emerging symptoms.

As soon as there is a pressing feeling in the chest, dizziness, it is necessary to put the child to bed. Do breathing exercises with him: take a deep breath, hold your breath for a couple of seconds as you exhale, and then exhale the remaining air. It is advisable to do this exercise several times. Don't put off visiting your doctor.

The doctor collects life history data (parental complaints, symptoms, what treatment was given, changes in the clinical picture, whether the mother was sick during pregnancy, whether there is a hereditary predisposition to the occurrence of such pathological conditions). Examines the child: measures the heart rate, pulse, conducts auscultation of the chest organs, and uses percussion to establish the border of the heart. Orders laboratory tests. Next he carries out treatment.

During drug treatment, vitamins and restorative drugs are used, and a diet is prescribed. Symptomatic treatment is also carried out. The doctor prescribes diuretics, anticholinergic drugs, sympathomimetics, and glucocorticosteroids.

If drug treatment does not bring a positive result, then the possibility of surgical intervention is considered. During this operation, a pacemaker is installed.

Diagnostics

To make a diagnosis you need to do:

electrocardiogram;
daily ECG monitoring.

Ultrasound (ultrasound examination) allows you to see the work of the heart in real time. This diagnostic method is also available nowadays. Daily monitoring (Holter) helps determine the work of the heart during the day. A special device is attached to the patient’s body and records any disturbances both during night sleep and during physical activity during the day.

Thanks to this study, it is possible to determine whether the blockade is passing. With Holter monitoring, a diary is kept in which the patient writes down all his complaints.

Characteristic features of the ECG with RBBB:

In lead V1, an rsR’ (rSR’) ECG is recorded; in some cases, both parts of the R’ wave are separated from each other by a notch (the origin of which is not entirely clear) located on its ascending knee.
In lead V6, an ECG of qRS type is recorded.
The STV1 segment is located below the isoline and the TV1 tooth is negative.
The STV6 segment is elevated and the TV6 wave is positive.

With RBBB, the QRS complex is widened and exceeds 0.12 s (6 cells). The diagnosis of “right bundle branch block” is made by ECG changes in the chest leads:

In leads V1, V2, the QRS complex has the form rsR' (can take the form: rSR', RSR', RsR', rR', M-shaped): the R'V1 wave is usually wide and high (R'V1 > rV1 ).
The STV1,V2 segment is usually located below the isoline, with the arc convexly facing upward.
The TV1 wave is negative, its apex is located close to the end of the wave (sometimes a negative T wave is also observed in other chest leads: V1-V4).
In leads V5, V6, the QRS complex looks like qRS.
The SV6 tooth is wide, rounded, mostly shallow, sometimes serrated.
The height of the tooth RV5,V6 may be slightly reduced compared to the norm.
The STV5,V6 segment is usually located on the isoline or slightly elevated.
The TV5,V6 tooth is positive.

From the above, it is clear that when moving from the right chest leads (V1, V2) to the left (V5, V6), the first r wave increases, turning into R, and the second R' wave decreases, gradually turning into the S wave (this is clearly visible on the ECG in the right table).

The electrical axis of the heart in RBBB is most often located vertically, but may also be normal, less often it is moderately deviated to the right or an axis of the SI-SII-SIII type is recorded. ECG shape in limb leads:

The ECG of the QRS complex in leads I, aVL is similar to the ECG in leads V5, V6 and has the form qRS.
The ECG of the QRS complex in leads III, aVF is similar to the ECG in leads V1, V2 and has the form rsR’ (rSR’).
In lead aVR, a late R wave is observed, and the QRS complex looks like QR or rSR’, the TaVR wave is negative.

RBBB is characterized by prolongation of the electrical ventricular systole QT. With incomplete blockade of the right leg, excitation may occur, but somewhat slowly. Often incomplete RBBB is observed with right ventricular hypertrophy and is a manifestation of hypertrophy, and not a conduction disorder.

With incomplete RBBB, the QRS complex is shaped like a right bundle branch block, but the QRS width is in the range of 0.08-0.11 s:

In chest leads V1, V2, the QRS complex has the form: rSr’, rSR’, rsR’, rsr’ (the activation time of the right ventricle in these leads is increased).
In the chest leads V5, V6, a complex of the qRS type is recorded (the SV5, V6 wave is slightly widened).
A late RaVR wave is quite common.
In some cases, there is a decrease in the STV1,V2 segment and a negative TV1,V2 wave, however, these signs are less pronounced than with a complete block.

In the ECG conclusion, following the nature of the rhythm, the location of the electrical axis of the heart is indicated; give a description of the blockade of the right leg (complete, incomplete); they mention the prolongation of the electrical systole of the ventricles; give a general description of the ECG. If there is simultaneously hypertrophy of the right or left ventricle, then its description is usually given before the general characteristics of the ECG.

Treatment

As you probably already guessed, you need to treat only those types of blockade in which there is an increased risk of developing cardiac death, or there is a pronounced desynchronization in the work of the upper (atria) and lower (ventricles) parts of the heart.

As a rule, in this case, we are talking about patients who have clinically significant and reliable signs of heart failure. Such patients are usually hospitalized in the department of interventional cardiac surgery and arrhythmology, or in the diagnostic department of a cardiology hospital.

Hospitalization is needed in order to:

choose good drug therapy if a diagnosed arrhythmia is observed against the background of the blockade;
exclude acute myocardial infarction when acute bundle branch block occurs (this is always suspicious, but, however, then the left leg is affected, not the right);
conduct an electrophysiological intracardiac study;
implant a pacemaker, or perform cardiac synchronization.

To reassure young people and their parents, it is safe to say that a pacemaker is not installed “just like that.”

For this there must be very strict indications, for example:

Alternating blockade of the legs (when a “walking” disorder occurs either in the left or right leg;
Atrioventricular block of the 3rd degree with the presence of fainting;
Leg blockade that occurred during acute myocardial infarction;
Severe heart failure of functional class 3 or 4, despite proper treatment.

Thus, it becomes clear that it is not the blockade of the right bundle branch that is being “treated” at all, but those conditions and diseases that it can aggravate or provoke. In conclusion, it must be said that to avoid confusion and ambiguous interpretation, if there are signs of blockade during an ECG, it is advisable for the patient to undergo an ultrasound of the heart.

Only then will it be possible to assess the thickness of the interventricular septum and draw a conclusion about the presence or absence of hypertrophy of the walls of the left and right ventricles. Only in this case will the diagnosis of blockade of any of the legs have actual diagnostic value, since it will be made taking into account the presence or absence of myocardial hypertrophy.

A patient with heart block is prescribed a diet. The diet must include fresh vegetables, fruits and juices. Fried, spicy and canned foods should be excluded from the menu. In case of heart failure, breathing exercises can be performed.

Exercise normalizes heart rate, reduces hypoxia, accelerates gas exchange and supplies cells with oxygen. Aerobic exercise relieves fatigue and improves performance. Breathing exercises are contraindicated if the patient has radiculitis, acute thrombophlebitis, severe spinal column injuries or a post-infarction condition.

If the patient has undergone surgery to install a pacemaker, then breathing exercises in this case will help strengthen the heart and develop joints. Doctors recommend doing three basic exercises a day. The first exercise is called “Wave”.

Starting position lying on your back. Legs are bent at the knees, feet pressed firmly to the floor. When you inhale, the chest increases in volume, and when you exhale, it falls and the stomach inflates. This exercise should be repeated 15-20 times.

The next exercise is “Frog”. Starting position sitting on a chair. Knees shoulder width apart. Elbows should be on your knees. As you exhale, lower your head down so that your forehead touches your knees. As you inhale, we rise to the starting position. Breathing is even and slow.
To complete the next task, sit on the floor and cross your legs in the lotus position.

Place your palms on your knees. The back is straight. The chin is slightly raised. Breathing is deep and easy. During breathing, the abdomen should not change in volume. As you exhale, hold your breath for a couple of seconds. The duration of the exercise is 5-7 minutes.

Drug treatment

If there are no heart diseases and pathologies. The main symptom of the disease is a disturbance in the heart rhythms of the bronchopulmonary system, then the dynamics of the development of the condition are monitored. However, in cases where the cause of the pathology is various diseases, it is necessary to treat the disease that accompanies this pathological condition.

The following medications are usually prescribed:

Vitamins: nicotinic acid, riboflavin, thiamine.
Phyto-based sedatives.
Drugs that prevent the formation of blood clots in blood vessels: Cardiomagnyl, Aspirin, ThromboAss. Statins: Atorvastatin, Rosuvastatin, Simvastatin.
Anti-inflammatory non-steroidal drugs: Diclofenac, Nimesulide (for inflammatory processes).
Antioxidant agents: Preductal, Carnitine, Ubiquinone, Mexidol.
Glycosides and diuretics: Digoxin, Strophanthin, Diuver, Lasix, Indapamide.

For cardiac ischemia, the drugs Cardiket and Nitroglycerin are prescribed. If the blockade is caused by hypertension, Losartan, Valsartan - antagonists, Perindopril, Lisinopril - ACE inhibitors are prescribed. It is also possible to use calcium channel antagonists (Amlodipine, Verapamil) or beta-blockers (Bisoprolol).

However, one should take into account the fact that these drugs reduce the heart rate. For blockade caused by bronchopulmonary diseases, adrenergic agonists for inhalation and glucocorticosteroids are used: Beclazon, Berotec, Berodual. Vitamin therapy is necessary for both complete and partial blockade.

With their help, it is possible to restore the conductivity of the impulse. Typically the vitamin complex includes:

thiamine;
nicotinic acid;
riboflavin.

Antioxidants help restore tissue; these drugs promote the release of breakdown products. If a complete blockade is combined with a left-sided blockade, then the only salvation is the implantation of an electrical stimulator.

In addition to drug therapy, a specialist may suggest surgical intervention, namely the installation of a pacemaker. To do this, an electrode is inserted into the right ventricle through the central vein. Indications for surgical treatment are:

Frequent loss of consciousness.
Malignant processes in the heart.
Ineffectiveness of drug treatment.

A diet with a predominance of fresh fruits and vegetables is also recommended for patients with this pathology. At the same time, limit the intake of fats and sugar.

Of course, with the rapid development of medicine and science, innovative technologies, today in our pharmacies you can find medicines for almost any disease. But, unfortunately, they have not yet come up with drugs that would not bring some negative effects to the human body.

In this regard, the issue of treatment with folk methods and means is so urgent. Today, in order to greatly improve the condition of a patient with this disease, a whole range of measures and means has been created, which includes taking various tinctures and herbal preparations, as well as some physical procedures.

The only exercises shown are dousing with cold water and various types of breathing exercises. Among the natural folk remedies, an herbal infusion is isolated, which is intended to maintain the immune nervous and endocrine systems in normal working condition. In addition, its positive effects include beneficial effects on the kidneys and liver.

To prepare such a tincture with microphytotherapeutic functions, you need the following ingredients:

20 gr. marsh calamus.
30 gr. silver birch leaves.
40 gr. red hawthorn flowers.
20 gr. sandy immortelle flowers.
20 gr. black elderberry flowers.
30 gr. valerian root.
10 gr. oregano.
20 gr. St. John's wort herb.
30 gr. calendula flowers.
10 gr. stinging nettle leaves.
20 gr. heart-shaped linden flowers.

This is the basic list of ingredients for making herbal infusion. But to achieve greater effect, you can also add to them:

peppermint leaves – 10 gr.
dandelion root – 20 gr.
plantain leaves – 20 gr.
motherwort – 30 gr.
chamomile – 20 gr.
common yarrow – 20 gr.
black currant leaves – 30 gr.
horsetail – 20 gr.
three-part series – 10 g.
rose hips – 50 gr.

The entire list of components must be crushed. Crushed herbs and roots are the basis for the mixture. They need to be mixed well. These proportions will last quite a long time, since to prepare this herbal infusion for 0.5 liters of boiling water you need to add only 0.5 grams of the resulting mixture.

The resulting drink should be left to steep for at least half an hour. The combination of all these plants and fruits has an incredibly beneficial effect on the human body. Cardiogram shows right and left leg block. It is recommended to take this herbal tincture three times a day in the amount of 100 ml before each meal.

It is best to brew the tincture and infuse it daily in the morning. If any excess remains, they can be used for washing or rinsing the mouth and throat. On average, if no discomfort was detected during administration, then you need to drink such a herbal infusion for a long time - at least 2 years without breaks.

Also, one of the popular tincture recipes for normalizing the nervous system, improving heart rate, strengthening sleep, and normalizing the walls of blood vessels is a recipe based on the tincture of the following plants:

4 tbsp. spoons of peony.
1.5 tbsp. spoons of valerian.
2 tbsp. spoons of hawthorn.
2 tbsp. spoons of motherwort.
1 tbsp. spoon of calendula.
1 tbsp. spoon of mint.

The list of ingredients is not as long as in the previous recipe, but the effect is no less useful. It’s even better to take it before the herbal infusion. The dosage schedule is simple: three times a day in an amount of 1 to 10 drops. Accordingly, you need to start with a minimum and increase the dosage over time.

The course of treatment should be carried out intermittently: we take the tincture for 1.5 months, rest for 3 weeks. After a break, the course can be repeated. Any disturbance in the functioning of the heart leads to adverse consequences and possibly other diseases.

This disease, in one form or another, is not uncommon in patients' medical records, but the prognosis is different for everyone. Often, if the patient does not have diseases of the respiratory or cardiovascular system in parallel, the prognosis is very favorable.

Consequences

Depending on the type of blockade that occurs, the consequences may be different. With incomplete blockade, the violations will not be serious; with complete blockade, the ability to conduct impulses can be completely lost. According to numerous studies, complete right bundle branch block usually occurs in old age, most often in men.

The pathology is accompanied by impaired contractions of the heart muscle. Such conditions can be either temporary or permanent. Complete blockade of the right bundle branch can only be detected through long-term observation of the work of the heart muscle.

In a healthy person, impulses are transmitted first to the interventricular septum, then to the left ventricle. If blocked, the signal is transmitted through the heart muscle tissue, and not directly. Transmission of impulses by this method leads to changes in the tissues of the right ventricle, as a result of which it expands and deforms.

The time the right ventricle remains in an excited state also deviates significantly from the norm. With complete blockade, signal transmission occurs only through the tissues of the interventricular septum. Excitation quickly passes to the left ventricle; due to anomalies in the structure of the heart, it affects the network of fibers.

With partial loss of conductivity, signal transmission occurs with a delay due to its passage through only one beam leg. Therefore, some heartbeats are simply excluded. Slowing down of impulse conduction can occur under the influence of factors such as:

disruptions in electrolyte metabolism;
poisoning of the body;
use of certain potent drugs.

Due to the occurrence of such disruptions in the functioning of the heart muscle, signal transmission occurs with a delay; in the right side of the heart, excitation does not reach normal levels.

A final diagnosis can be made based on the ECG results. All heart rhythm disturbances will be clearly visible on the cardiogram. In this case, deviations appear in the form of enlarged teeth with lowered areas.

Prevention of heart disease

Cardiovascular diseases claim millions of lives every year. This increase in mortality is due to the fact that in most cases people lead an unhealthy lifestyle. Alcohol abuse, smoking, office work, and lack of physical activity lead to the fact that even people at a young age suffer from heart problems.

The situation is worsened by the fact that society has stopped eating healthy. Snacking on junk food leads to obesity, which has a detrimental effect on the heart. Therefore, prevention should include changing your usual lifestyle. There are simple rules that will significantly reduce the risk of developing heart disease.

Eat more vegetables and fruits. Choose lean meats and bake them rather than fry them. Experts advise reducing the amount of saturated fat you consume. It is better to drink green tea throughout the day, as it has beneficial properties and has a beneficial effect on the vascular system. Get at least 8 hours of sleep.

Regular physical activity is required. Just 20 minutes of daily walking will reduce the risk of death from heart disease. Avoid passive smoking, which is no less harmful. It is better to replace strong alcoholic drinks with dry red wine. Try to eliminate stressful situations.

Remember that blockade of the right leg of the heart does not make a person’s life limited and boring.

Complete blockade of the right bundle branch (complete RBBB) is characterized by a gross disruption of the conduction of the excitation wave through this part of the conduction system. In most cases, this pathology indicates serious organic damage to the myocardium, especially the right ventricle of the heart. Despite this, complete blockade of the right bundle branch is not accompanied by any dangerous symptoms, with the exception of clinical signs of the underlying cardiac disease.

The cause of the development of complete bundle branch block is diseases and pathological conditions leading to organic damage to the myocardium of the right ventricle of the heart. These include:

Myocardial infarction (especially posterior).
Myocarditis.
Post-infarction cardiosclerosis.
Chronic rheumatic heart disease, and others.

In some situations, complete RBBB can develop due to a sudden overload of blood in the right parts and chambers of the heart. The most common cause in this case is massive pulmonary embolism, a life-threatening condition that develops as a result of blood clots entering the lumen of the corresponding vessels. However, for the most part, complete blockade of the His bundles is a direct consequence of serious cardiac pathology.

Occasionally, complete RBBB develops during therapy with antiarrhythmic drugs of classes 1A and 1C, as well as due to fluid and electrolyte disturbances. These cases should be considered as casuistic.

Symptoms

Complete blockade of the right bundle branch of His does not have independent symptoms. In some cases, it is possible to develop bradyarrhythmia, that is, a disturbance in the heart rhythm with a tendency to slow down the heart rate. Most often, complete RBBB is detected accidentally during a routine electrocardiographic study or during emergency admission of a patient to the hospital due to the development of myocardial infarction.

A great danger is posed by complete blockade of the His bundle - a condition in which the synchronicity of excitation of the atria and ventricles disappears. In fact, in this case, two independent conduction systems arise in the heart (one for the atria, the other for the ventricles), which greatly affects hemodynamics and the prognosis of the disease.

Diagnostics

The diagnosis of complete RBBB is made on the basis of electrocardiography. During the study, altered ventricular complexes shaped like the letter “M” are determined, as well as a significant expansion of the modified QRS complex (duration more than 0.12 seconds). Due to the fact that complete RBBB often occurs against the background of altered myocardium, the ECG may reveal signs of other conduction disorders.

Other research methods, the use of which is necessary when identifying complete RBBB, are:

Holter monitoring.
Echocardiographic study.
Laboratory blood tests, especially lipid profile and determination of cardiac-specific enzymes.
Intracardiac electrophysiological study (if implantation of a pacemaker is planned).

Complete blockade of the right bundle branch does not require specific therapy, since in itself it is not dangerous to the patient’s health. It is necessary to treat the underlying and leading heart disease, which caused the development of this type of disturbance in the conduction of electrical impulses inside the ventricles.

Consequences

Typically, complete RBBB is well tolerated by patients and occurs without any independent clinical manifestations. Unlike blockade of the left bundle branch, it is not accompanied by significant circulatory disorders, although it somewhat aggravates the course of chronic cardiovascular failure.

Data from large studies demonstrate that the development of complete right bundle branch block due to known structural myocardial disease is associated with an increased risk of cardiovascular mortality over a 4-year period. In this regard, the diagnosis of complete RBBB is the first step towards a full and comprehensive cardiac screening for the timely detection of heart pathology and its treatment.

If the conduction of impulses through special muscle cells in the myocardium, called bundles of His, is disrupted, then a complete or partial block of the legs is diagnosed on the ECG. There are no symptoms or patients complain of dizziness, weakness and fainting. For treatment, the cause must be eliminated (heart attack, sclerosis, heart defects, hypertension); some patients require a pacemaker.

📌 Read in this article

Bundle of His - what is it in the heart

The bundle of His in the heart is a section of the conduction system. Figuratively, it can be represented as a bundle of electrical wires passing current. It first runs along the wall between the ventricles, then divides into 2 legs, and the left one then further diverges into anterior and posterior. His fiber impulses are received from the atrioventricular junction and transmitted to small Purkinje cells that branch in the walls of the ventricles.

What is a bundle branch block?

Conducting fibers consist of a trunk (located in the septum between the ventricles), right and left branches. The right one descends immediately to the right ventricle, and the left one is first divided into 2 parts (anterior and posterior), and then passes to the left ventricle. Subsequently, the branches of the His bundle branch in the cardiac muscle, forming Purkinje tracts.

The role of the branches of His is to perceive the contraction signal from the sinus and aotrioventricular nodes and transmit it to all parts of the cardiac muscle of the ventricles. This forces them to contract in the correct rhythm.

If an obstacle occurs in the form of inflammation, necrosis, sclerosis in the myocardium, their work is blocked. If the area of damage is minor, then there may be no symptoms; with a complete blockade, contractions occur less frequently than normal. This is due to the conduction of impulses along roundabout paths, which disrupts the synchronicity of the parts of the heart.

Reasons for the development of pathology

The right bundle branch (RBBB) is damaged by overload and damage to the right ventricular myocardium in the following cases:

narrowing of the mitral orifice,
tricuspid valve insufficiency,
pulmonary hypertension,
hole in the septum between the atria,
overdose of cardiac glycosides and beta blockers.

Myocardial infarction is one of the causes of bundle branch block

Parts of the left bundle branch (LBB) are blocked due to changes in the myocardium of the left ventricle:

ischemia,
dystrophic and dishormonal processes,
hypertrophy with hypertension, aortic defects, mitral insufficiency,
bacterial and .

Symptoms in adults and children

Disturbance of signal transmission along the His bundles does not have independent clinical signs, as it occurs secondary to existing disease of the heart or large vessels. If the blockade is partial or only of one branch, especially the right one, then the patient may not be aware of it, and such a deviation from the norm can only be detected on an ECG, more often with Holter monitoring.

With complete damage to all 3 branches (PNPG and 2 parts of the left), the volume of blood ejected from the ventricles decreases. In such cases, characteristic symptoms appear:

dizziness;
visual impairment;
fainting attacks of the Morgagni-Adams-Stokes type;
bradycardia;
interruptions in rhythm
difficulty breathing;
slowing down contractions until the heart stops completely.

Bradycardia

Types of His blockade

The legs of His can be blocked individually or all at once; there is also an isolated lesion of one branch of the left leg, as well as their various combinations. There are periodic or constant variants; one electrocardiogram may first show a blockade of one and then another branch.

Right leg

The impulse for the right ventricle comes from the left and along the left side of the septum when completely blocked; its conduction slows down when incomplete. The manifestations are minimal, can be detected in a completely healthy person and do not cause further complications. If it occurs due to cardiac pathology, then shortness of breath and increased fatigue are usually associated with the underlying disease.

Anterior branch of the LBP

Conduction disturbances affect the anterior and lateral side of the left ventricle. Signals are sent to them along the back wall from bottom to top. Most often it is found with myocardial hypertrophy due to hypertension, overload due to heart defects and myocardiopathy, one of the reasons is anterior wall infarction.

Posterior branch

The electrical signal travels along individual Purkinje fibers from the anterior sections of the left ventricle from top to bottom, reaching the posterior wall with a delay. A similar condition is caused by a heart attack or sclerosis, calcium deposits in the area of conductive fibers.

Whole left leg

Partial blockades of one branch give minimal manifestations, but complete blockade of LBP is caused by an extensive infarction or a pronounced inflammatory or dystrophic process that covers the myocardium of the left ventricle. Therefore, with this pathology, cardialgia, dizziness, and arrhythmia are noted.

Complete and incomplete blockade

With a partial blockade, the contraction wave passes with a slight delay, since it reaches the target quite quickly through numerous alternative paths. The rhythm is not disturbed or bradycardia develops; the severity of clinical manifestations depends on the cause that led to the blockade.

Complete blocking is characterized by:

inability to transmit signals to the ventricles;
the occurrence of foci of excitation in atypical places;
parts of the heart contract in a chaotic rhythm, pulse rate - from 20 to 40 per minute;
insufficient release of blood into the arterial network.

Transient right bundle branch block

Blockade of the right and left bundle branch is possible in permanent as well as transient versions. In the second case, it is also called intermittent. This means that it occurs under provoking conditions. For example, it is called:

increased blood pressure;

acceleration or deceleration of pulse, complex rhythm disturbances;

infection;

decompensation of heart disease, diabetes mellitus (deterioration of condition);

progression of heart failure;

changes in the electrolyte composition of the blood, especially potassium levels;

severe attack of angina;

taking medications - hormones, cardiac glycosides, medications that affect blood pressure.

After the patient enters a state of rest or success in treating the underlying disease is achieved, the blockade of the leg disappears. Daily recording of a cardiogram (Holter monitoring) helps to identify a transient conduction slowdown, but a temporary blockade is often not visible on a regular ECG.

Three-bundle branch block

If there is a three-bundle branch block, this means that both ventricles receive signals from the most intact of the three branches. They may contract more slowly than normal or at their own rhythm.

In the incomplete version, this is manifested by dizziness, weakness and shortness of breath during physical activity, and possible pain in the heart. With further progression, interruptions and sensations of tremors in the heart area and fainting occur.

When the passage of the signal completely stops, attacks of loss of consciousness, bluish skin with convulsive muscle twitching appear. Three-bundle acute blockade of the His bundle causes cardiac arrest and, if assistance is not provided in a timely manner, ends in the death of the patient.

ECG signs and other diagnostic methods

Most often, a conventional ECG is used, but if there is doubt about the diagnosis, then a transesophageal technique or 24-hour monitoring is additionally prescribed. In order to establish the cause, examination is carried out using echocardiography, CT and MRI.

ECG symptoms depend on the type and combination of blocked branches:

Blockade of PNPG - the right chest leads reveal the Rsr, rSR complexes, they look like the letter M, in the left ones - S is wider than normal, QRS is more than 0.12 seconds.
LBP blockade – wide complexes with a jagged apex in the left leads, in the right leads – abnormal complexes, split S.

Leg block in the heart: symptoms in women

Incomplete or temporary blockade of one leg or branch of His in the heart does not cause symptoms in women and men. If there is a complete cessation of the movement of impulses, then the rhythm slows down and the ejection of blood from the heart decreases. This leads to insufficient nutrition of the organs, but the brain and myocardium suffer the most. The manifestations are:

darkening of the eyes;
fainting;
rare, irregular pulse, interruptions;
difficulty breathing;
attacks of heart pain.

Often, with a transient blockade, the condition is good at rest, but with physical or emotional stress, the patient feels a lack of air, an attack of dizziness occurs, and a state of fainting occurs.

Right bundle branch block during pregnancy

If a right bundle branch block is detected during pregnancy in a woman who has never suffered from heart disease before, then this is the norm. At a young age, this phenomenon does not cause circulatory problems and disappears on its own.

Causes associated with cardiac pathology include:

hypertension,
angina pectoris
heart defect.

All of them have characteristic symptoms and to exclude them, an EchoCG, ECG and pressure measurement are sufficient. In doubtful cases, Holter cardiogram monitoring and a blood test for rheumatic tests are prescribed.

What are the dangers of left bundle branch block?

Blockade of the left bundle branch is dangerous when combined with a complete block of the right one. There is a disconnection of the rhythm of contractions of the heart chambers. Against this background, the volume of blood entering the bloodstream from the heart decreases, and episodes of loss of consciousness are possible. In severe cases, a complex form of arrhythmia appears and even cardiac arrest of varying duration occurs.

If one leg is affected, then the ventricle (right, left, respectively) will receive a bioelectric impulse with a delay, but contraction will still occur. Therefore, blockade of only the right (left) bundle branch is not dangerous, but requires treatment for the condition that caused it. For asymptomatic cases, observation and regular annual examinations (ECG, blood tests) are sufficient.

Is left bundle branch block curable?

Left bundle branch block can be treated, but to do this it is necessary to identify and eliminate the disease that caused it, and there is no special therapy only for the block. Since this condition is not a disease, but only its symptom, the main diagnosis for the patient is:

valve defect;
septal defect;
post-infarction, post-myocardial cardiosclerosis;
calcification;
cardiomyopathy (viral, diabetes, hormonal disorders, gout, allergic, toxic, alcoholic).

Therefore, they use drugs that are needed in each specific case - those that reduce blood pressure, dilate blood vessels, improve myocardial nutrition, and anti-inflammatory drugs.

Left bundle branch block develops in cardiomyopathy

Treatment of bundle branch block

Treatment of the underlying disease is carried out; vitamins, Coenzyme Q, Thiotriazolin, Mildronate are prescribed to improve blood supply to the myocardium. Pressure reduction is carried out with angiotensin-converting enzyme blockers (Lisinopril, Capoten), beta-blockers and calcium antagonists are avoided, as they slow down conduction in the myocardium.

Indications for installation of a pacemaker (artificial rhythm source or cardioverter):

blockade of 3 bundles,
complete block for signals from the atrium,
contraction rhythm below 40 per minute,
attacks of loss of consciousness.

If the blockade of the legs occurs in the acute stage of a heart attack, there is a complete blockade of the LBP, PNPG with one left branch, then temporary cardiac stimulation is recommended. To do this, an electrode is inserted into the right ventricle through the central vein.

If there are no clinical manifestations, then patients are advised to be monitored by a cardiologist and periodic ECG monitoring.

Watch the video about right bundle branch block:

How dangerous is the condition?

Completely blocking electrical impulses increases the risk of cardiac arrest and can cause sudden cardiac arrest, which can be fatal. Morgagni-Adams-Stokes attacks, which occur when the blood supply to the brain is disrupted, can also be life-threatening, especially if the patient is driving or operating other complex machinery at the time.

Complications of bundle branch block include:

attacks of tachycardia of ventricular origin,
and ventricular flutter,
circulatory failure,
thromboembolism.

Ventricular fibrillation as a complication of bundle branch block

Prognosis for the patient

If the blockade is discovered accidentally during an ECG examination, and there are no signs of a deficiency in the blood supply to the internal organs, then the prognosis for such patients is favorable. This may be a variant of the heart structure; no treatment is required.

An unfavorable outcome of the blockade is observed in patients with extensive infarction, uncompensated defects, and massive myocardial degeneration. It should be noted that the blockade that occurs in such situations is a sign of the negative dynamics of the disease; it increases the risk of complications and death.

Lifestyle when identifying a problem

If the examination reveals no deviations from the norm, and there are only ECG signs of blockade, then the patient is recommended to maintain physical activity in the same volumes as healthy people.

With the development of conduction disorders in cardiac patients, the loads are limited, but not completely canceled. Stress, overwork, excess animal fats in the diet, smoking and alcohol abuse have a negative impact on the course of the disease.

After installing a pacemaker, you should avoid devices with an electromagnetic field, security detectors in supermarkets and airports, and high-voltage electrical lines. When using a mobile phone, you need to hold it on the right side.

Bundle branch block is not a separate disease, but a sign of a violation of the contraction signal through the heart muscle. Partial blockades of the PNPG and 1 left branch are asymptomatic. If 3 branches are completely blocked or a similar disorder occurs against the background of a heart attack, sudden cardiac arrest may occur. Treatment of the underlying disease is prescribed; in case of fainting attacks, installation of a pacemaker is indicated.