Right Bundle Branch Block

Cross section of heart showing conduction system.Right bundle branch block is a problem in the heart’s electrical system. Your heart uses electrical signals to keep pumping normally. Normal heartbeats are generated in the upper right heart chamber called the right atrium. The electrical signals reach the ventricles, the main heart pumping chambers. They travel over specialized wires called bundle branches. There are 2 main bundle branches with one in the right ventricle and the other in the left ventricle. In right bundle branch block, the right bundle branch fails to conduct electricity. The signals from the atria reach the ventricles only through the left bundle branch. Instead of the left and right ventricles squeezing at the same time, the right ventricle squeezes just a little later.

What causes right bundle branch block?

Right bundle branch block can result from a number of conditions, such as:

  • Heart disease from high blood pressure

  • Chronic obstructive lung disease (COPD)

  • Pulmonary embolism

  • Cardiomyopathy

  • Myocarditis

  • Heart attack

  • Congenital heart disease

  • Surgery or other procedures on the heart

In some case, the cause of right bundle branch block is not known. The heart otherwise appears normal.

What are the symptoms of right bundle branch block?

Right bundle branch block does not cause symptoms on its own. It may make symptoms of other heart conditions worse, such as heart failure.

How is right bundle branch block diagnosed?

Right bundle branch block is diagnosed with an electrocardiogram (ECG). This test looks at the heart’s rhythm. The condition is often found during an ECG for another reason. Your doctor may want to check you for other health conditions. He or she may ask about your medical history and give you a physical exam. You may also have other tests, such as:

  • Echocardiogram, to look at your heart’s motion and blood flow through the heart

  • Testing to check the health and function of your lungs

  • Blood tests to look at your overall health

How is right bundle branch block treated?

If you have no symptoms and no other heart conditions, no treatment is recommended. If you have or may have heart disease, your healthcare provider will want to keep track of your heart health. In particular, if you develop right bundle branch block after a heart attack, it increases the risk of death and therefore requires more intensive treatment.

Living with right bundle branch block

Your doctor may give you more instructions about how to manage your overall heart health. You might need to make lifestyle changes. These may include losing weight, quitting smoking, or improving your diet.

Keep track of any heart symptoms you have. See your doctor regularly, even if you don’t have any symptoms. Make sure all your healthcare providers know about your right bundle branch block.


When should I call my healthcare provider?

Call your healthcare provider right away if you have any of these:

  • New symptoms

  • Chest pain

  • Fainting

  • Shortness of breath