Catheter-induced right bundle branch block: Practical implications for the cardiac electrophysiologist
Hussam Ali1, Pierpaolo Lupo1, Sara Foresti1
1Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy.
Journal of Cardiovascular Electrophysiology
|September 1, 2023
Summary
Catheter-induced right bundle branch block (CI-RBBB) is a common, usually transient, finding during cardiac procedures. While often benign, it can offer diagnostic insights but requires careful consideration in specific clinical scenarios.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- The right bundle branch (RBB) is prone to block from catheter contact during right-heart catheterization.
- Catheter-induced RBB block (CI-RBBB) is a frequent observation in electrophysiology and ablation procedures.
Purpose of the Study:
- To provide a comprehensive review of CI-RBBB's electrophysiological implications.
- To highlight its diagnostic utility and potential pitfalls in cardiac electrophysiology.
Main Methods:
- Review of electrophysiological phenomena associated with CI-RBBB.
- Analysis of CI-RBBB's impact on the intrinsic conduction system and arrhythmias.
Main Results:
- CI-RBBB is typically transient, allowing for reliable baseline comparisons.
- It can provide valuable diagnostic information but may lead to complications.
- Avoidance is recommended in specific conditions like baseline LBBB or certain right-sided arrhythmias.
Conclusions:
- CI-RBBB is an important, though often overlooked, electrophysiological event.
- Understanding its transient nature and diagnostic value is crucial for electrophysiologists.
- Careful consideration and avoidance strategies are necessary in high-risk scenarios.
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