Bundle Branch Block, Right

Right Bundle Branch Block

Criteria for complete RBBB in adults from the AHA/ACC.

1. QRS ≥ 120 msec (or 110-119 for incomplete BBB)
2. rsr′, rsR′, or rSR′ in leads V₁or V₂. The R′ or r′ deflection is usually wider than the initial R wave. In a minority of patients, a wide and often notched R wave pattern may be seen in lead V₁and/or V₂.
3. Wide S wave (i.e. S wave of greater duration than R wave or greater than 40 ms) in leads I and V6 (the lateral leads).

4. Normal R peak time in leads V₅and V₆but greater than 50 ms in lead V₁.

Of the above criteria, the first 3 should be present to make the diagnosis. When a pure dominant R wave with or without a notch is present in V₁, criterion 4 should be satisfied.

References

J Am Coll Cardiol. 2009 Mar 17;53(11):976-81. https://www.ncbi.nlm.nih.gov/pubmed/19281930