The only treatment required for isolated right bundle branch block (RBBB) is periodic follow-up and evaluation. Individuals with RBBB and selected heart disease (untreated or following surgical treatment) may require an annual or biennial ECG to evaluate for interval changes. In these individuals, ECGs may reveal progression of the underlying conduction defect or other potential rhythm abnormalities (eg, sinus bradycardia, supraventricular or ventricular ectopy).
Inpatient ECG telemetry may be required if patients with right bundle branch block (RBBB) are at risk for clinically significant arrhythmia (see Natural history).
Children with right bundle branch block should be referred to a pediatric cardiologist for careful and complete evaluation. If right bundle branch block is associated with a syndrome, consultation with other appropriate specialists is indicated. Examples include an ophthalmologist for patients with Kearns-Sayre syndrome and a geneticist, an orthopedic surgeon, and a pulmonologist for patients with muscular dystrophy.
Patient education and activity
Patients, parents, and primary medical providers should be informed that right bundle branch block per se does not typically predict specific future problems or management concerns.
Patients with right bundle branch block are not specifically limited in their activities; however, associated conditions may influence activity restrictions.