Pediatric Right Bundle Branch Block Treatment & Management

Updated: Jul 26, 2018
  • Author: Glenn T Wetzel, MD, PhD; Chief Editor: Syamasundar Rao Patnana, MD  more...
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Treatment

Medical Care

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 electrocardiography (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 RBBB are at risk for clinically significant arrhythmia (see History).

Consultations

Children with RBBB 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.