RESEARCH ARTICLE


Structural Causes of Right Bundle Branch Block—Time for a Closer Look?



James Ker*
Department of Physiology, University of Pretoria, Pretoria, South Africa, PO Box 24318, Gesina, Pretoria, South Africa, 0031


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© James Ker; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Physiology, University of Pretoria, Pretoria, South Africa, PO Box 24318, Gesina, Pretoria, South Africa, 0031; Tel: +2712-3430078; Fax: +2712-3430079; E-mail: jker@wol.co.za


Abstract

Right bundle branch block is an electrocardiographic phenomenon with specific criteria.

Currently, two specific forms of right bundle branch block are acknowledged, a proximal and a distal variant. A vast array of pathologies can cause proximal, distal or even combined forms of right bundle branch block.

In this study it is suggested that a third type of right bundle branch block exist: one caused by a subaortic muscular tendon in the left ventricle, leading to an increased velocity of conduction in the left ventricle, with a resultant “relative” right bundle branch block. It is concluded that it is necessary (and time) to take a closer look at endoventricular structures in the assessment of structural causes of right bundle branch block.

Keywords: Right bundle branch block, subaortic, tendon, structural..