Chapter 10- Bundle Branch Block
right bundle branch block
normal impulses until the bundle of his is reached, the impulse must reverse and complete depolarization via the left ventricle. the change is direction creates the RSR pattern, can be viewed in V1 and V6
bundle branch block (BBB)
occurs when one or both of the ventricular pathways is damaged or delayed has p wave and wide QRS greater than .12 sec
Leads I, III, III
LBBB and RBBB will be the same in what leads?
negative deflection
LBBB create what type of QRS deflection?
The P wave preceding each QRS
indicated the impulse in coming from the SA node
Left bundle branch block (LBBB)
A block in the electrical conduction through the left bundle; evidenced by a wide QRS in lead V1 and V6
QS complex
A deep Q/S wave with no preceding R wave. Can indicate a left bundle branch block.
cardiac disease, drugs or. MI
BBB may be a cause of
positively deflected
Is RBBB positively deflected or negatively deflected?
where RBBB and LBBB can be seen
V1 and V6
no, but the underlying condition causing them might be, ex: myocardial infarction
are BBBs life threatening?
RSR pattern
change in impulse direction from right to left
wide QRS
delay in ventricular depolarization/BBB
supraventricular rhythm
evidence of P waves can be referred to as
underlying rhythm
the heart rhythm that would be present if the abnormal impulses were ignored or removed from the tracing
pacemaker for 24 hrs, may require permanent pacemaker or emergency cardiac care
treatment for bundle branch
the basic rhythm along with the BBB
what must always be determined with a BBB
V1 and V6 (precordial leads)
where specific characteristics of the BBB can be viewed
V1
which lead can distinguish RBBB from LBBB?
Right bundle branch block (RBBB) classification
widened QRS (>0.12s); double peaked "rabbit ears" QRS in V1 (best to look in V1 and V2); T wave can look abnormal - inverted