Right bundle branch block is a heart rhythm finding where electrical signals travel more slowly through the right side of the heart. Many people with right bundle branch block have no symptoms and feel well, but some notice lightheadedness, fainting, or palpitations. It can be found at any age but is more common in older adults and people with heart or lung conditions. Right bundle branch block often lasts long term and the outlook is usually good, with low mortality when no other heart disease is present. Treatment focuses on the underlying cause, and most people need only monitoring, while a pacemaker is considered if right bundle branch block occurs with significant slow heart rhythms or symptoms.
Overview
Right bundle branch blockSymptoms
Right bundle branch block often causes no symptoms. Some people notice skipped beats, lightheadedness, fainting, chest discomfort, or shortness of breath—usually from an underlying heart or lung problem. Seek urgent care for new chest pain, fainting, or worsening breathlessness.
Outlook and prognosis
Most people with right bundle branch block (RBBB) feel well and live normal, active lives. When RBBB occurs without heart disease, it usually stays stable and needs only routine follow-up. If RBBB appears with heart conditions, your care team tailors monitoring and treatment to reduce risks.
Causes and risk factors
Right bundle branch block can appear without a clear cause or from heart strain. Links include aging, coronary disease, congenital heart defects, pulmonary embolism, and pulmonary hypertension. Risk increases with being male, high blood pressure, and prior cardiac surgery.
Genetic influences
Genetics play a limited role in right bundle branch block. Most cases are acquired from heart or lung conditions, aging, or procedures. Rarely, inherited heart muscle or electrical disorders increase risk; family history matters if RBBB appears young or alongside other cardiac issues.
Diagnosis
Diagnosis of right bundle branch block is usually made on an electrocardiogram (ECG) showing a characteristic pattern. Doctors may repeat the ECG, compare prior tracings, and assess heart structure with echocardiography; further testing depends on symptoms and suspected causes.
Treatment and drugs
Right bundle branch block is managed based on symptoms and its cause. Many people need only monitoring, heart‑healthy habits, and follow‑up ECGs; others may benefit from treating lung disease, blood pressure, or coronary issues. If conduction is slow plus dizziness or fainting, pacemaker evaluation may help.
Symptoms
Many people with Right bundle branch block feel no obvious symptoms in daily life. If early symptoms of Right bundle branch block show up, they’re often subtle—brief lightheadedness, a fluttering heartbeat, or getting winded faster on stairs. Symptoms can come and go, and sometimes reflect another heart issue rather than the electrical delay itself. A healthcare professional can help sort out what’s typical aging and what warrants a closer look.
Most people with Right bundle branch block feel fine day to day. It’s often found during a routine ECG done for another reason.
Brief spells of lightheadedness or dizziness can happen, especially when standing up quickly or during exercise. If this is new, frequent, or worsening, talk with a healthcare professional.
Feeling your heart skip, race, or flutter can be unsettling. When these sensations are new or frequent—especially if you’ve been told you have Right bundle branch block—it’s worth being evaluated.
Passing out or almost passing out can occur with significant heart rhythm problems. If you faint, seek urgent medical care.
How people usually first notice Right bundle branch block?
Many people learn about a right bundle branch block (RBBB) only after a routine ECG during a checkup, a pre-op assessment, or a sports physical, because it often causes no symptoms. When signs do appear, they’re usually nonspecific—such as brief lightheadedness, mild shortness of breath with exertion, or palpitations—which can prompt a clinician to order an ECG that shows the conduction delay. In practice, the “first signs of right bundle branch block” are most often the ECG pattern itself rather than something you feel, and doctors may then check for underlying causes if needed.
Types of Right bundle branch block
Right bundle branch block (RBBB) can look different from person to person, from a harmless ECG finding to a sign of underlying heart disease. People may notice different sets of symptoms depending on their situation. Clinicians often describe them in these categories: complete versus incomplete patterns, isolated RBBB without other heart issues, and RBBB that appears with another conduction delay or a known heart condition. Understanding the main types of RBBB can help you and your clinician talk through early symptoms of right bundle branch block and what they might mean for monitoring or treatment.
Complete RBBB
The right-sided electrical signal is fully delayed, creating a classic RBBB pattern on the ECG. Many people have no symptoms, though some notice brief lightheadedness or reduced exercise tolerance. Doctors usually look for an underlying cause such as prior heart attack, pulmonary issues, or structural heart disease.
Incomplete RBBB
The delay in the right bundle is partial, so the ECG pattern is similar but less pronounced. Most people feel well and discover it during a routine check. It can remain stable for years or progress to complete RBBB in some cases.
Isolated RBBB
RBBB appears without other heart rhythm problems or structural heart disease. People often remain symptom-free and need only periodic follow-up. The focus is on watchful monitoring rather than treatment unless new findings arise.
RBBB with LAFB
RBBB occurs with left anterior fascicular block (a bifascicular pattern). Some may experience near-fainting or palpitations, especially with exertion. Clinicians monitor closely because the combined blocks can increase the risk of slower heart rhythms.
RBBB with structural disease
RBBB is found alongside conditions like coronary artery disease, cardiomyopathy, or lung-related heart strain. Symptoms may include shortness of breath, chest discomfort, or reduced stamina, driven more by the underlying disease than the block itself. Care targets the root condition while keeping an eye on conduction changes.
Exercise- or rate-related RBBB
The RBBB pattern shows up mainly at higher heart rates, such as during exercise or stress. People might notice palpitations or breathlessness only with activity. Stress testing or ambulatory monitoring helps confirm this pattern and guide activity planning.
Post-procedure RBBB
RBBB appears after heart procedures, especially valve or septal interventions. It may be temporary but sometimes persists and requires follow-up. Management depends on recovery of conduction and the presence of symptoms.
What genetics can tell you about symptoms
Some people with inherited changes in SCN5A or LMNA genes develop right bundle branch block, where electrical signals to the right side of the heart slow or stall, leading to dizziness, fainting, or no symptoms at all. These variants can also raise risks of arrhythmias or heart failure.
Causes and risk factors
Right bundle branch block can appear on its own or from conditions that strain or scar the right side of the heart.
Age, coronary artery disease or a past heart attack, heart muscle inflammation (myocarditis), and heart muscle disease can raise the chance of it.
Lung problems that raise pressure in the lungs, like a blood clot in the lungs (pulmonary embolism) or long-standing lung disease, can lead to right bundle branch block.
Lifestyle risk factors for right bundle branch block include smoking, high blood pressure, high cholesterol, and diabetes.
Some people are born with it or have a family tendency, sometimes with congenital heart defects, and some risks are modifiable (things you can change), others are non-modifiable (things you can’t).
Environmental and biological risk factors
Right bundle branch block (RBBB) is a change in the heart’s electrical pathway that many discover on a routine ECG, often without symptoms. Many do not notice early symptoms of right bundle branch block, so knowing what can raise the chance of RBBB helps you recognize when to check in. Doctors often group risks into internal (biological) and external (environmental). Below are common biological and environmental risk factors linked with RBBB.
As we age, natural wear and small scars can develop in the heart’s electrical wiring. This can slow signals along the right bundle and raise the chance of RBBB.
Changes that enlarge or stiffen the right side of the heart can strain the right bundle. Cardiomyopathy or long-standing valve problems can contribute and make RBBB more likely.
High pressure in the lung’s blood vessels (pulmonary hypertension) forces the right side of the heart to work harder. Over time, this can interfere with signal travel through the right bundle and lead to RBBB.
Severe, long-term lung disease can raise lung pressure and enlarge the right ventricle. That added stress can make RBBB more likely.
Genetic risk factors
Some people develop right bundle branch block due to inherited factors that affect the heart’s electrical wiring or structure. Genetic causes of right bundle branch block include changes in single genes, chromosomal conditions, and inherited heart malformations. Carrying a genetic change doesn’t guarantee the condition will appear. A careful family history can help clarify whether genetic testing might be useful.
Family history: Having close relatives with conduction disease suggests shared inherited factors. Patterns seen across parents, siblings, or children can point to a genetic contribution.
SCN5A variants: Changes in the SCN5A sodium channel gene can slow the heart’s electrical signal along the right bundle. These variants are a well-known cause of conduction disease that can include right bundle branch block.
LMNA-related disease: Variants in the LMNA gene can disturb the heart’s electrical system and its muscle support. People in affected families may develop bundle-branch block along with other conduction delays.
NKX2-5 variants: This heart-development gene is linked to atrial septal defects and conduction problems. Families with NKX2-5 changes often show delays in the right-sided pathway on the heart tracing.
Holt-Oram syndrome: Inherited changes in the TBX5 gene can affect arm/hand formation and the heart’s structure and wiring. Right bundle branch block is a recognized feature in some people with Holt-Oram.
ARVC gene variants: Genes such as PKP2 or DSP can lead to arrhythmogenic right ventricular cardiomyopathy, which affects the right side of the heart. Damage in this area can disrupt the right bundle and appear as right bundle branch block on testing.
Chromosomal syndromes: Genetic conditions like Down syndrome or 22q11.2 deletion often come with heart differences present at birth. These differences raise the likelihood of conduction abnormalities.
Inherited PCCD: Familial progressive cardiac conduction disease can begin with a right bundle branch block and progress over time. Known genes include SCN5A, LMNA, and DES.
Brugada pattern genes: Variants tied to Brugada syndrome can produce a right-sided conduction pattern that looks similar on the heart tracing. In some families, true conduction block can also be part of the picture.
Lifestyle risk factors
Lifestyle choices mainly influence conditions that stress the heart’s structure and the lung circulation, which can make a right-sided conduction delay more likely to appear or persist. Some people have this finding incidentally, but habits that drive high blood pressure, coronary disease, or pulmonary hypertension increase the chance it shows up or worsens. The items below describe lifestyle risk factors for Right bundle branch block and how modifying them may lower risk or progression.
Tobacco damages lung vessels and raises pulmonary pressures, straining the right ventricle and its conduction pathways. Quitting lowers right-heart stress and reduces the chance of conduction disturbances like RBBB.
Excess salt worsens hypertension and ventricular remodeling that can affect conduction tissue. Cutting sodium helps reduce blood pressure and cardiac wall stress that may contribute to RBBB.
Diets high in saturated fat and ultra-processed foods promote coronary artery disease that can injure the conduction system. A heart-healthy eating pattern supports vessels and reduces scarring that can manifest as RBBB.
Sedentary habits drive obesity, hypertension, and diabetes, all linked to structural heart changes associated with bundle branch blocks. Regular moderate exercise supports right-ventricular function and may reduce RBBB risk.
Risk prevention
Some cases of right bundle branch block can’t be prevented, but you can lower your chances by protecting your heart and treating conditions that strain it. Prevention works best when combined with regular check-ups. Many people have no early symptoms of right bundle branch block, so routine ECGs are usually done when you have risk factors or new symptoms like dizziness or fainting. The steps below focus on heart-healthy habits and medical monitoring that reduce the risks tied to conduction problems.
Keep your blood pressure in a healthy range to reduce strain on the heart’s electrical pathways. Work with your clinician on targets and medications if needed.
Manage cholesterol and blood sugar to protect heart muscle and blood vessels. Good control lowers conditions that can contribute to right bundle branch block.
Avoid tobacco and vaping, which damage blood vessels and the heart over time. Stopping smoking can quickly improve heart health.
Aim for regular moderate exercise most days of the week. Build up gradually and stop if you notice chest pain, fainting, or new palpitations.
Transmission
Right bundle branch block is a heart conduction finding seen on a heart tracing (ECG/EKG), not an infection. It can’t be transferred between people and is not contagious. It also isn’t typically inherited on its own. Rarely, an underlying heart condition that runs in families—such as a structural difference present from birth or a heart muscle problem—may be linked to right bundle branch block, and any family screening is guided by that condition rather than the block itself.
When to test your genes
Consider genetic testing if a right bundle branch block appears before age 50, is unexplained, or comes with fainting, palpitations, cardiomyopathy, or concerning ECG features. Testing is also reasonable with a family history of sudden cardiac death or inherited arrhythmias. Results can guide monitoring, sports clearance, and medication choices.
Diagnosis
Right bundle branch block (RBBB) is often picked up during a routine check-up or when someone is being evaluated for chest discomfort, palpitations, or shortness of breath. For many, there are no obvious day-to-day symptoms, but the finding still deserves a careful look to check heart and lung health. Doctors focus on how right bundle branch block is diagnosed using an EKG and then add tests to look for underlying causes when needed. Many people find reassurance just knowing what their tests can—and can’t—show.
Your clinician asks about symptoms like dizziness, fainting, chest pain, or breathlessness, and reviews medications and past heart or lung issues. They check blood pressure, oxygen level, and listen to the heart and lungs.
This simple test records the heart’s electrical pattern and usually confirms RBBB. It also shows whether the block is complete or incomplete and if other rhythm issues are present.
Doctors compare current and older tracings to see if RBBB is new or long-standing. A new finding may prompt a deeper search for possible causes.
An ultrasound of the heart checks pumping strength, valve function, and right‑sided pressures. It helps identify conditions that can be linked to RBBB, such as strain from lung disease or structural heart changes.
Stages of Right bundle branch block
Right bundle branch block does not have defined progression stages. It’s a heart conduction pattern seen on an ECG and often stays the same over time, so it isn’t tracked by “mild-to-severe” levels. Many people have no early symptoms of right bundle branch block, and doctors confirm it with an electrocardiogram (ECG); an echocardiogram or blood tests may be ordered if there’s a need to check the heart muscle or valves. Different tests may be suggested to help confirm the finding, look for a cause, and decide on follow-up, especially if you’ve had fainting, chest discomfort, or palpitations.
Outlook and prognosis
Many people ask, “What does this mean for my future?”, and the honest answer is that the outlook with right bundle branch block (RBBB) depends on what else is going on with your heart. If RBBB is found by chance in someone with no symptoms and a normal heart evaluation, it often stays stable for years and doesn’t limit daily life or lifespan. The outlook is not the same for everyone, but people with underlying heart disease—such as prior heart attack, heart failure, pulmonary hypertension, or significant valve problems—may have a higher risk of future rhythm issues or worsening heart function.
Understanding the prognosis can guide planning and day-to-day choices. On its own, RBBB rarely causes symptoms, though some notice brief lightheadedness, skipped beats, or fatigue during exertion; early symptoms of right bundle branch block are often subtle and easy to miss. The main concern is less about the “block” itself and more about what it might be signaling underneath, so your clinician may recommend an echocardiogram, basic labs, and sometimes monitoring to check for slow heart rhythms or atrial fibrillation. In people with otherwise healthy hearts, long-term survival is usually similar to those without RBBB; when serious heart disease is present, outcomes are driven mostly by that condition rather than the conduction pattern.
Looking at the long-term picture can be helpful. RBBB very rarely progresses to complete heart block; when it does, or if significant pauses occur, a pacemaker may be advised to prevent fainting and reduce risk. Mortality risk tied specifically to isolated RBBB is low, but if RBBB appears during or after a heart attack, or alongside heart failure or lung disease, it can be a marker of higher risk and warrants closer follow-up. Keep regular appointments—small adjustments can improve long-term health.
Long-term effects
Right bundle branch block (RBBB) affects the heart’s electrical wiring on the right side. Many people have no day-to-day limitations, and when present, early symptoms of right bundle branch block can include brief lightheadedness or palpitations. Long-term effects vary widely, and often depend on whether there is another heart or lung condition. For most, isolated RBBB stays stable for years with a normal life expectancy.
Many feel well for the long term. Right bundle branch block alone often causes no symptoms.
RBBB can reflect strain on the right heart from lung disease, valve issues, or past heart surgery. Outlook depends more on the underlying condition than the block itself.
Over time, RBBB rarely progresses to complete heart block. The chance is higher if other electrical conduction problems are present.
Occasional lightheadedness or near-fainting can occur. With RBBB, this is uncommon and usually prompts doctors to check for other causes.
How is it to live with Right bundle branch block?
Living with right bundle branch block (RBBB) is often uneventful, because many people have no symptoms and discover it incidentally on an EKG done for another reason. If you do feel anything, it’s usually mild—occasional palpitations, light fatigue, or shortness of breath with exertion—and the main day‑to‑day adjustment is keeping up with routine checkups so your care team can watch for any underlying heart conditions. Family members and friends typically won’t notice a difference, though they may share in the reassurance of clear explanations and a plan if new symptoms arise. For most, life continues normally, with attention to heart‑healthy habits and prompt care if anything changes.
Treatment and drugs
Right bundle branch block (RBBB) doesn’t always need treatment—many people have no symptoms, and it’s simply found on an ECG done for another reason. Care focuses on what’s causing RBBB or what’s happening alongside it: your doctor may check for heart disease, high blood pressure, lung conditions, or effects of certain medicines, and treat those directly. If RBBB comes with symptoms like fainting, dizziness, or a very slow heartbeat, or occurs with other conduction problems, a pacemaker may be considered to keep the heart’s rhythm steady. Alongside medical treatment, lifestyle choices play a role, including managing blood pressure, cholesterol, diabetes, and avoiding smoking. Ask your doctor about the best starting point for you.
Non-drug treatment
For many, a right bundle branch block (RBBB) is found on a routine ECG and doesn’t change daily life. Most people do not notice early symptoms of right bundle branch block, but your team may still check for hidden heart or lung issues. Non-drug treatments often lay the foundation for staying well, focusing on monitoring, heart-healthy habits, and addressing any triggers. Your plan depends on whether RBBB stands alone or comes with other heart conditions.
Periodic ECGs and checkups track whether right bundle branch block stays stable. Your doctor may adjust follow-up if you develop symptoms like fainting, chest discomfort, or shortness of breath.
Focus on vegetables, fruits, whole grains, lean proteins, and less salt to support your heart. Not smoking and limiting alcohol protect blood vessels and overall heart rhythm.
Most people with right bundle branch block can be active with moderate exercise. Build up gradually, and pause if you notice dizziness, chest pain, or unusual breathlessness.
Screening and treatment for sleep apnea can lower strain on the heart. Using a CPAP device as prescribed may improve energy and blood pressure control.
Your genes may have an impact on how drugs work for you
Medications for people with right bundle branch block can work differently based on genes that affect drug processing in the liver and sensitivity in heart cells. Genetic differences may change how well beta‑blockers, antiarrhythmics, or anticoagulants work or what dose is safest.
Pharmacological treatments
Right bundle branch block (RBBB) itself doesn’t have a specific medicine that “fixes” the electrical pattern; treatment centers on any heart condition or rhythm issue that comes with it. Many people have no early symptoms of right bundle branch block, so medicines are used when there’s high blood pressure, coronary artery disease, heart failure, or irregular heart rhythms. Alongside drug therapy, monitoring and device treatments remain important. Your care team tailors choices to your symptoms, risks, and overall heart health.
Metoprolol, bisoprolol, or carvedilol can slow a fast heart rhythm and lower blood pressure. In people with right bundle branch block and palpitations or coronary disease, they may ease strain on the heart. They can cause tiredness or dizziness, so dosing is adjusted slowly.
Lisinopril, ramipril, losartan, or valsartan reduce blood pressure and protect the heart over time. If right bundle branch block occurs with heart failure or hypertension, these drugs can help the heart pump more efficiently. Kidney function and potassium are checked regularly.
Furosemide or torsemide help the body shed extra fluid to ease swelling and shortness of breath in heart failure. This lowers pressure inside the heart and lungs, which can reduce symptoms. Electrolytes are monitored to prevent low potassium or sodium.
Spironolactone or eplerenone improve outcomes in heart failure and reduce fluid buildup. They can be added when symptoms persist despite other therapies. Blood tests track potassium and kidney function.
Genetic influences
Most cases of right bundle branch block (RBBB) are not inherited; they tend to appear with aging or after strain or scarring in the heart or lungs. Family history is one of the strongest clues to a genetic influence. When RBBB shows up at a young age, comes and goes, or appears alongside fainting, palpitations, or a known heart muscle problem, doctors may look for an underlying inherited rhythm or muscle condition. RBBB can also be seen with certain heart differences present from birth, where genes that guide heart development play a role. In these situations, genetic testing for right bundle branch block may be considered, though testing usually aims to find a broader electrical or muscle cause rather than a single “RBBB gene.” A genetics specialist can review your family history and help decide whether testing or ongoing screening would be helpful for you and your relatives.
Is Right bundle branch block genetic?
Genetics play a limited role in right bundle branch block. Most cases are acquired from heart or lung conditions, aging, or procedures. Rarely, inherited heart muscle or electrical disorders increase risk; family history matters if RBBB appears young or alongside other cardiac issues.
Pharmacogenetics—how genetics influence drug effects
Most people with right bundle branch block (RBBB) don’t need medication for the block itself. When treatment is needed—for example, for a related rhythm problem or underlying heart disease—your genes can influence how you respond to certain drugs and what dose is safest. Genetics is only one factor in how medicines affect you. Some antiarrhythmic medicines and certain drugs for mental health conditions can slow the heart’s electrical signals; people who naturally break these medicines down more slowly may have higher levels and a greater risk of worsening conduction or even complete heart block. Inherited electrical conditions that affect the heart’s sodium channels can overlap with right bundle branch block, and in those situations doctors may steer away from specific rhythm drugs and focus on close monitoring or a pacemaker if needed. Pharmacogenetic testing for Right bundle branch block isn’t routine, but it may be considered if you’ve had unusual reactions to rhythm medicines or there’s a family history of significant conduction disease.
Interactions with other conditions
Because there are often no early symptoms of Right bundle branch block, its impact usually depends on which other heart or lung conditions are present. It commonly shows up alongside problems that strain the right side of the heart, such as long-standing lung disease, pulmonary hypertension, or a blood clot in the lung (pulmonary embolism). Doctors call it a “comorbidity” when two conditions occur together. In some congenital heart differences, especially an atrial septal defect, an RBBB pattern is common and may prompt a closer look for a small hole between the heart’s upper chambers. When Right bundle branch block occurs with other wiring issues—like a slow heartbeat or another delay on the left side—it can raise the chance of fainting or, rarely, progression to more serious heart block, so closer follow-up is important. In heart failure or cardiomyopathy, it may add to shortness of breath by making the heart’s squeeze less coordinated; in coronary artery disease it can appear during or after a heart attack, though it usually doesn’t hide the telltale ECG changes the way a left-sided block can.
How genes can cause diseases
Humans have more than 20,000 genes, each carrying out one or a few specific functions in the body. One gene instructs the body to digest lactose from milk, another tells the body how to build strong bones and another prevents the body's cells from beginning to multiply uncontrollably and developing into cancer. As all of these genes combined are the building instructions for our body, a defect in one of these genes can have severe health consequences.
Through decades of genetic research, we know the genetic code of any healthy/functional human gene. We have also identified that in certain positions on a gene, some individuals may have a different genetic letter from the one you have. We call these hotspots "Genetic Variations" or "Variants" in short. In many cases, studies have been able to show that having the genetic letter "G" in the position makes you healthy, but having the letter "A" in the same position disrupts the gene function and causes a disease. Genopedia allows you to view these variants in genes and summarizes all that we know from scientific research, which genetic letters (Genotype) have good or bad consequences on your health or on your traits.
History
Throughout history, people have described sudden pauses, skipped heartbeats, or brief dizziness that seemed to come and go. In a quiet moment at home or while walking up a flight of stairs, some noticed a flutter or a thump in the chest, then felt fine minutes later. Only with the rise of careful bedside observation and, later, heart tracing tests did patterns behind these moments begin to make sense.
From early theories to modern research, the story of right bundle branch block centers on how the heart’s electrical signal travels. Doctors first saw clues on the electrocardiogram (ECG) in the early 1900s, when jagged lines on paper showed a delay in how the right side of the heart was activated. Initially understood only through symptoms, later the ECG pattern became the reliable signpost. As ECG machines spread into clinics and ambulances, more people were tested, including those without symptoms, and Right bundle branch block was found far more often than anyone expected.
Over time, descriptions became more precise. Specialists learned to tell apart a complete block from an incomplete one, and to separate right bundle patterns from other causes of a widened QRS. Once considered rare, now recognized as a relatively common ECG finding, Right bundle branch block showed up in healthy adults, older adults, athletes, and people with lung or heart conditions. This wider view changed the conversation: RBBB could be a normal variant for some, while in others it pointed to strain on the right side of the heart or scarring from past illness.
In recent decades, knowledge has built on a long tradition of observation. Large population studies tracked people with Right bundle branch block for years, showing that many do well without treatment, especially when no other heart disease is present. At the same time, heart imaging and catheter studies clarified when RBBB might signal an underlying issue, such as high pressure in the lungs, a past heart attack, or changes after heart surgery. Clinicians also mapped how RBBB can appear during procedures, with pacemakers, or after chest trauma, and how it behaves alongside other rhythm problems.
Today, the historical arc helps explain why doctors look at the whole picture. An ECG showing Right bundle branch block is a clue, not a verdict. The modern approach—pairing the tracing with symptoms, exam findings, and, when needed, imaging—grew directly from a century of careful records and follow‑up. Understanding where these ideas came from reassures many living with Right bundle branch block that a familiar, well‑studied pattern on the ECG can mean different things in different people, and that care is tailored accordingly.