Right bundle branch block (RBBB) is a conduction abnormality affecting the electrical signals in the right ventricle of the heart. This causes a delay in the contraction of the right ventricle compared with the left ventricle.

While it is typically not a serious diagnosis, in some cases, it can indicate heart damage from another condition.

This article explores the symptoms, treatment, outlook, and more for RBBB.

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A person with RBBB typically does not have symptoms and may not know they have the condition. On rare occasions, a person may faint due to a severe block, though this is unlikely to occur unless other heart issues are present.

Healthcare professionals often find the condition incidentally during an electrocardiogram (ECG), a test that evaluates the heart’s electrical activity.

Several situations that lead to changes in the heart muscle or tissues may cause RBBB. These may include:

  • Structural changes: Some people are born with congenital heart abnormalities. Others may experience certain conditions that cause structural changes to the heart that lead to RBBB development.
  • Trauma: Sometimes, physical injury, such as an impact to the chest, can cause changes that affect the heart and cause RBBB.
  • Hyperkalemia: This is the medical term for high potassium levels in the blood. In rare cases, it can affect the conduction of electrical impulses in the heart and cause RBBB.
  • Inflammation: Certain infections can damage the area where the right bundle branch electrical conduction flows, causing RBBB. An example is myocarditis, which refers to heart muscle inflammation.
  • Increased right ventricular pressure: Conditions that increase pressure in the heart’s right ventricle can cause RBBB. This may include a pulmonary embolism, where there is a blood clot in the lung, or pulmonary hypertension.
  • Medical procedures: Certain procedures, such as right heart catheterization, can cause RBBB.
  • Conduction system disease: Progressive damage to the heart’s conduction system due to scarring can lead to RBBB.

Risk factors

Risk factors for RBBB include:

Doctors diagnose RBBB using an ECG test, a noninvasive procedure that measures the heart’s electrical activity and can detect conditions such as RBBB.

Healthcare professionals place small electrodes on the person’s chest, arms, and legs during an ECG. These electrodes connect to a machine that records the heart’s electrical signals and creates a graphical representation of the electrical activity.

In most cases, when RBBB is present without any other symptoms or underlying health issues, it does not require additional evaluation or treatment. However, there are several situations when a person may require treatment due to the underlying cause of RBBB.

For example, If an individual has heart failure and decreased pumping ability in combination with RBBB, doctors may suggest cardiac resynchronization therapy as treatment.

In cases where a pulmonary embolism is present, doctors will prescribe medications such as anticoagulants to treat the blood clot.

On the rare occasion that an individual with RBBB experiences fainting episodes or if there are other significant conduction disturbances, doctors may recommend implanting a pacemaker to help regulate the heart’s rhythm.

Having RBBB typically does not require a person to change their diet or lifestyle significantly. This is especially true when RBBB is present without underlying heart disease or symptoms.

It is always advisable to consult with a doctor for personalized guidance on self-care practices and necessary lifestyle modifications.

The outlook for a person with RBBB is generally favorable. Doctors often consider it a benign condition that does not significantly impact an individual’s health.

Some research suggests individuals with RBBB are more likely to have decreased exercise capacity when compared with those without RBBB.

If RBBB is accompanied by other cardiac anomalies or underlying heart disease, the outlook may depend on the severity and management of those conditions.

Does RBBB affect a person’s life expectancy?

Having RBBB may impact a person’s life expectancy in certain circumstances. However, RBBB alone does not necessarily determine a person’s life expectancy.

Research indicates that individuals with RBBB who have not previously received a diagnosis of cardiovascular disease are at a higher risk of experiencing cardiovascular-related and all-cause mortality.

People with RBBB who also experience a heart attack or heart failure have a greater chance of mortality.

RBBB alone is typically not associated with significant complications. However, in some cases, it may be associated with certain complications or indicate underlying health issues.

A person’s overall outlook will depend on their medical history and other risk factors.

RBBB is often the result of other underlying conditions or structural changes in the heart and is not always preventable.

Maintaining heart health and decreasing the risk of other underlying conditions is beneficial. General measures that can contribute to heart health include:

It is generally advisable to contact a doctor, such as a cardiologist, if a person has a new diagnosis of RBBB or experiences any concerning symptoms.

The doctor can assess the overall impact of RBBB on the individual’s health, determine what underlying causes may be triggering the atypical conduction, and decide on the best treatment plan.

When should a person go to the ER for RBBB?

Doctors typically do not consider RBBB alone an emergency.

However, there are certain circumstances where it is appropriate to seek emergency care, such as if a person experiences:

The following are answers to some commonly asked questions about RBBB.

Is RBBB permanent?

RBBB typically develops progressively over time and does not go away. However, there may be cases where RBBB is temporary and goes away when doctors treat the underlying condition.

Is RBBB a serious heart condition?

Although RBBB alone is not a significant health concern in most cases, it can indicate a serious underlying heart condition.

Is it safe to get the COVID-19 vaccine if a person has RBBB?

The American Heart Association recommends that people with heart disease and associated risk factors get a COVID-19 vaccination. This is because people with such underlying conditions have a higher risk of developing complications from COVID-19.

If people with RBBB are concerned about how a vaccine will affect them, they can speak with a doctor.

Cardiovascular health resources

Visit our dedicated hub for more research-backed information and in-depth resources on cardiovascular health.

Right bundle branch block (RBBB) is a cardiac conduction abnormality that can occur due to various underlying conditions affecting the heart’s electrical system. While doctors do not consider RBBB alone a serious condition, it may indicate an underlying cardiac issue that is serious, especially if symptoms are present.

People with RBBB typically have no symptoms and may learn they have it after an ECG. The condition itself does not usually need treatment. However, the underlying cause of RBBB may require treatment.

Consulting with a cardiologist is important for a proper diagnosis, evaluation, and personalized management.