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right bundle branch block

English translation: A delay in conduction of the electrical impulse of the heart at the...

GLOSSARY ENTRY (DERIVED FROM QUESTION BELOW)
English term or phrase:right bundle branch block
Selected answer:A delay in conduction of the electrical impulse of the heart at the...
Entered by: Elena Sgarbo (X)

18:05 Jun 29, 2002
English language (monolingual) [PRO]
Medical
English term or phrase: right bundle branch block
No further context...looking for an explantion of the term
Petra Molenaar
A block (rather, a delay) in conduction of the electrical impulse of the heart at the...
Explanation:
... level of the right bundle branch of His.

I agree with my colleagues' explanations.

For more detail on RBBB and its implications, Patra, you may want to check out our updated chapter "Electrocardiography" in Topol's textbook, or an article where we discuss the association of RBBB and acute infarction (this, available also in PubMed):

• Sgarbossa EB, Wagner GS. Electrocardiography. In: Topol EJ, ed. Textbook of Cardiovascular Medicine, 2nd edition Lippincott-Williams & Wilkins Publishers, Philadelphia, PA 2002.

. Sgarbossa EB, Pinski SL, Topol EJ, Califf RM, Barbagelata A, Goodman SG, Gates KB, Granger CB, Miller DP, Underwood DA, Wagner GS. Acute myocardial infarction and complete bundle branch block at hospital
admission: clinical characteristics and outcome in the thrombolytic era.
GUSTO-I Investigators. Global Utilization of Streptokinase and t-PA
[tissue-type plasminogen activator] for Occluded Coronary Arteries.
Journal of the American College of Cardiology. 31(1):105-10, 1998 Jan.

Abstract
OBJECTIVES: We sought to assess the outcome of patients with acute myocardial infarction (MI) and bundle branch block in the thrombolytic era. BACKGROUND: Studies of patients with acute MI and bundle branch block have reported high mortality rates and poor overall prognosis. METHODS: The North American population with acute MI and bundle branch block enrolled in the Global Utilization of Streptokinase and t-PA [tissue-type plasminogen activator] for Occluded Coronary Arteries (GUSTO-I) trial was matched by age and Killip class with an equal number of GUSTO-I patients without conduction defects. RESULTS: Of all 26,003 North American patients in GUSTO-I, 420 (1.6%) had left (n = 131) or right (n = 289) bundle branch block. These patients had higher 30-day mortality rates than matched control subjects (18% vs. 11%, p = 0.003, odds ratio [OR] 1.8) and were more likely to experience cardiogenic shock (19% vs. 11%, p = 0.008, OR 1.78) or atrioventricular block/asystole (30% vs. 19%, p < 0.012, OR 1.57) and to require ventricular pacing (18% vs. 11%, p = 0.006, OR 1.73). Bundle branch block also carried an independent 53% higher risk for 30-day mortality. Thirty-day mortality rates for patients with complete, partial and no reversion of the bundle branch block were 8%, 12% and 20%, respectively (two-tailed chi-square test for trend 5.61, p = 0.02, OR 0.34 for complete reversion, OR 0.55 for partial reversion). CONCLUSIONS: Bundle branch block at hospital admission in patients with acute MI predicts in-hospital complications and poor short-term survival.


Selected response from:

Elena Sgarbo (X)
Grading comment
4 KudoZ points were awarded for this answer



SUMMARY OF ALL EXPLANATIONS PROVIDED
5 +3explanation
Catherine Bolton
5bloqueio do feixe da derivação direito..
airmailrpl
4 +1Right bundle branch block (RBBB)
Daniela McKeeby
4 +1A block (rather, a delay) in conduction of the electrical impulse of the heart at the...
Elena Sgarbo (X)


  

Answers


5 mins   confidence: Answerer confidence 5/5 peer agreement (net): +3
explanation


Explanation:
Bundle branch block is a "delay or block of conduction through either of the branches [the right, in your case] of the bundle of His, causing one ventricle to be activated and contract before the other".

Source: Gould-Chiampo Medical Encyclopedia

Catherine Bolton
Local time: 04:48
Native speaker of: English
PRO pts in pair: 98

Peer comments on this answer (and responses from the answerer)
agree  Daniela McKeeby: sorry, didn't see your answer
7 mins
  -> That's OK, it happens!
agree  Elisabeth Ghysels: the bundle of His is part of the cardiac electrical conduction system: http://sprojects.mmi.mcgill.ca/cardiophysio/anatomybundlehis... ask again, if you need greater detail on any of these very specific questions
1 hr
agree  Dr Janine Manuel BSc BHB MBChB
20 hrs
Login to enter a peer comment (or grade)

10 mins   confidence: Answerer confidence 5/5
bloqueio do feixe da derivação direito..


Explanation:

Bundle Branch Block - Texas Heart Institute Heart Information ...
... which branch is affected. If the block is located in the right bundle
branch, it is called right bundle branch block. If the block ...
www.tmc.edu/thi/bbblock.html - 33k - Em cache - Páginas Semelhantes

Right Bundle Branch Block - [ Traduzir esta página ]
A 55 year old man with 4 hours of "crushing" chest pain. Right Bundle
Branch Block. wide QRS, more than 120 ms (3 small squares); secondary ...
www.ecglibrary.com/rbbb.html - 2k - Em cache - Páginas Semelhantes

Left Bundle Branch Block - [ Traduzir esta página ]
... Left Bundle Branch Block Right Bundle Branch Block. Left Posterior
Hemiblock. Left Anterior Hemiblock. Book, Home Page. ...
Descrição: Examination of valve murmurs. Detailed topics such as characteristics, timing, severity, causes and...
Categoria: Health > Conditions and Diseases > ... > Heart Disease > Murmurs
www.fpnotebook.com/CV64.htm

--------------------------------------------------
Note added at 2002-06-29 18:18:20 (GMT)
--------------------------------------------------

typo
bloqueio do feixe da derivação direita

--------------------------------------------------
Note added at 2002-06-29 18:34:16 (GMT)
--------------------------------------------------

BRB = bloqueio do ramo direito

Morte Súbita em Paciente com Bloqueio de Ramo Direito e ...
... morte súbita abortada e que apresentavam no eletrocardiograma (ECG), fora das crises,
um padrão de bloqueio de ramo direito (BRD) e elevação persistente do ...
www.epub.org.br/abc/6604/tabr12.htm

57 - Facilitação e efeito de Wedensky durante bloqueio de ramo ...
... de ramo cujo desbloqueio se verifica no ou nos ciclos pós-extrassistolicos atriais, nodais AV ou ventriculares, sendo 1 caso de bloqueio do ramo direito e 6 ...
www.infarctcombat.org/TP/qhm-57.htm

Memórias sobre nossa contribuição para o estudo dos bloqueios ...
... como na derivação AVR, com deflexão S relativamente espessada em D1, aVL, V5
e V6, mostrando-se assim com padrões semelhantes do bloqueio de ramo direito ...
www.infarctcombat.org/memorias/bdr.htm

CLASSIFICAÇÃO DAS ARRITMIAS
... suas divisões. - Bloqueio Completo do Ramo Principal Direito. - Bloqueio Incompleto do Ramo Principal Direito. - Bloqueios Divisionais. ...
www.unb.br/fs/clm/labcor/ecgarrit.htm

--------------------------------------------------
Note added at 2002-06-29 18:35:22 (GMT)
--------------------------------------------------

Sorry for the portuguese - need to pay more attention

airmailrpl
Brazil
Local time: 23:48
Native speaker of: Native in EnglishEnglish, Native in PortuguesePortuguese
PRO pts in pair: 1195
Login to enter a peer comment (or grade)

11 mins   confidence: Answerer confidence 4/5Answerer confidence 4/5 peer agreement (net): +1
Right bundle branch block (RBBB)


Explanation:
Right bundle branch block: Bundle branch block is not a cardiac arrhythmia per se. It usually causes no symptoms and requires no direct treatment but is often of adverse prognostic significance. Right bundle branch block ( RBBB ) can occur in apparently normal individuals. Its most important relationship is with anterior MI, when it indicates substantial damage. The new appearance of RBBB may suggest a progressive cardiac condition (sarcoid, etc). While distorting the QRS complex, it does not seriously prejudice the ECG diagnosis of MI.



Your heart has a natural "pacemaker" called the sinoatrial (SA) node. The SA node is a specialized group of cells at the top of your heart's upper-right chamber (the right atrium). Anywhere between 60 and 100 times a minute, the SA node sends an electrical impulse throughout your heart to cause it to beat (contract).

When the SA node sends an electrical impulse, that impulse first travels through the heart's upper chambers (the atria). It then passes through a small group of cells called the atrioventricular (AV) node. The AV node checks the impulse and sends it along a track called the bundle of His. The bundle of His divides into a right bundle branch and a left bundle branch, which lead to your heart's lower chambers (the ventricles).
Sometimes the electrical impulse cannot travel throughout the heart because a part of the heart's conduction system is "blocked." If an impulse is blocked as it travels through the bundle branches, you are said to have bundle branch block.






    Reference: http://www.texasheartinstitute.org/bbblock.html
    Reference: http://www.mmip.mcgill.ca/heart/rbbb.html
Daniela McKeeby
United States
Local time: 22:48
Native speaker of: Native in EnglishEnglish, Native in RomanianRomanian
PRO pts in pair: 40

Peer comments on this answer (and responses from the answerer)
agree  Dr Janine Manuel BSc BHB MBChB
20 hrs
Login to enter a peer comment (or grade)

1 hr   confidence: Answerer confidence 4/5Answerer confidence 4/5 peer agreement (net): +1
A block (rather, a delay) in conduction of the electrical impulse of the heart at the...


Explanation:
... level of the right bundle branch of His.

I agree with my colleagues' explanations.

For more detail on RBBB and its implications, Patra, you may want to check out our updated chapter "Electrocardiography" in Topol's textbook, or an article where we discuss the association of RBBB and acute infarction (this, available also in PubMed):

• Sgarbossa EB, Wagner GS. Electrocardiography. In: Topol EJ, ed. Textbook of Cardiovascular Medicine, 2nd edition Lippincott-Williams & Wilkins Publishers, Philadelphia, PA 2002.

. Sgarbossa EB, Pinski SL, Topol EJ, Califf RM, Barbagelata A, Goodman SG, Gates KB, Granger CB, Miller DP, Underwood DA, Wagner GS. Acute myocardial infarction and complete bundle branch block at hospital
admission: clinical characteristics and outcome in the thrombolytic era.
GUSTO-I Investigators. Global Utilization of Streptokinase and t-PA
[tissue-type plasminogen activator] for Occluded Coronary Arteries.
Journal of the American College of Cardiology. 31(1):105-10, 1998 Jan.

Abstract
OBJECTIVES: We sought to assess the outcome of patients with acute myocardial infarction (MI) and bundle branch block in the thrombolytic era. BACKGROUND: Studies of patients with acute MI and bundle branch block have reported high mortality rates and poor overall prognosis. METHODS: The North American population with acute MI and bundle branch block enrolled in the Global Utilization of Streptokinase and t-PA [tissue-type plasminogen activator] for Occluded Coronary Arteries (GUSTO-I) trial was matched by age and Killip class with an equal number of GUSTO-I patients without conduction defects. RESULTS: Of all 26,003 North American patients in GUSTO-I, 420 (1.6%) had left (n = 131) or right (n = 289) bundle branch block. These patients had higher 30-day mortality rates than matched control subjects (18% vs. 11%, p = 0.003, odds ratio [OR] 1.8) and were more likely to experience cardiogenic shock (19% vs. 11%, p = 0.008, OR 1.78) or atrioventricular block/asystole (30% vs. 19%, p < 0.012, OR 1.57) and to require ventricular pacing (18% vs. 11%, p = 0.006, OR 1.73). Bundle branch block also carried an independent 53% higher risk for 30-day mortality. Thirty-day mortality rates for patients with complete, partial and no reversion of the bundle branch block were 8%, 12% and 20%, respectively (two-tailed chi-square test for trend 5.61, p = 0.02, OR 0.34 for complete reversion, OR 0.55 for partial reversion). CONCLUSIONS: Bundle branch block at hospital admission in patients with acute MI predicts in-hospital complications and poor short-term survival.




Elena Sgarbo (X)
Native speaker of: Native in SpanishSpanish
PRO pts in pair: 294

Peer comments on this answer (and responses from the answerer)
agree  Dr Janine Manuel BSc BHB MBChB
19 hrs
  -> Thanks Janine
Login to enter a peer comment (or grade)



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