Right Bundle Branch Block and Bifascicular Block

0:00 - Introduction
0:15 - Electrical Conduction System of the Heart
3:40 - Right Bundle Branch Block
13:18 - Rule of Appropriate T-Wave Discordance
16:20 - STEMI and Right Bundle Branch Block
17:30 - Bifascicular Block
20:52 - Wide Complex Tachycardias with RBBB Morphology in lead V1
#Electrocardiography #ECGinterpretation #12LeadECG #ACLS

[@CritER2023]

Thanks, Tom! I truly appreciate you. Thank you for sharing your knowledge and expertise in EKGs. You are very inspiring and for me, you make my job as an RN a very exciting one.

[@TomBouthillet]

Thank you, Paul! I appreciate you, too. It's gratifying to be able to share medical education with folks I've never met.

[@tesneemmuhammad279]

Amazing explanation. I never had such clear understanding. May God bless you.

[@youngmedlion8631]

Been waiting for a video like this for some time now. Systematic, concise and wholesome approach. Best regards, 6th year medicine student (Europe)

[@TomBouthillet]

Thank you for the comment! I'm glad you're getting something out of my videos.

[@dasmed9950]

I really appreciate your approach and the way you break all the rules down into a very simple, easy way to understand. Thanks very much.

[@TomBouthillet]

You’re welcome, Da Smed!

[@mirtsakalbazidou527]

Congratulations! Excellent video, very good explanation!

[@LionMD99]

Wow I am amazed by your mastery of cardiac mechanics!

[@TomBouthillet]

Thank you, Alyssa! I’ve been fascinated by electrocardiography for many years.

[@tesneemmuhammad279]

Amazing content. Beautifully explained. Thanks a lot

[@TomBouthillet]

Thank you very much!

[@PKusienya4439]

Masterpiece explanation. Thank you so much 👏👏👏👏

[@TomBouthillet]

You are welcome!

[@murvygoaz5903]

Awesome video, sir. I was struggling to understand bundle branch blocks, and this really helped!

[@HardCoreOrDead]

Very comprehensive and in detail covering all red flags..thanks

[@TomBouthillet]

Thank you very much! Glad to help.

[@Nohamostafa]

I appreciate your videos it really help me alot snd I am sure it help other , god bless you as you benefite many people with your knowlage and your skilles of teaching , such great skills that you have and great effort that you put . Thank you

[@TomBouthillet]

That’s very kind of you. Thank you!

[@NuriaBarreras]

Thank you. Excellent explanation.

[@warodomphaenthong]

Very well explained. Thank you very much.❤

[@hostertran5966]

Thank you, that's a great lesson.

[@TomBouthillet]

Glad you found it to be useful!

[@rahmoh4145]

Thank you so much for your exclamations in a very easy, understanding way . You make learning so so easy . 🙏🙏🙏🙏🙏

[@TomBouthillet]

My pleasure! Glad you enjoyed i.t

[@brunildealbanese9419]

You are simply awesome

[@TomBouthillet]

That is very kind of you! Thank you so much.

[@meghanpritchard7520]

Very helpful, thank you!

[@TomBouthillet]

Glad it was helpful!

[@Xman695]

Great discussion...helped me.

[@experiencedmua9962]

I'm not even in medical school and this is very comprehensive. Thank you. Trying to understand this as I am experiencing this but yet my echo came back normal.

[@dimahjar]

Excellent video .. Thank you so much ..

[@TomBouthillet]

You are most welcome!

[@sonyainsd]

I have a RBBB. I have no symptoms so Dr said not to worry about it. I told him I get SOB when weightlifting and he said that is normal so long as I don’t get winded walking up a flight or two of stairs. Tend to have blood pressure on the lower side 109/60. Otherwise, I am super healthy. Doc said they only address it if there are issues. 🤷🏼‍♀️

[@dajatotu]

Brilliant! Thank you. :)

[@mcclado]

awesome! so easy to understand...

[@TomBouthillet]

Glad you enjoyed it!

[@user-oc4kd9oe9e]

It really helps me ! Thanks a lot

[@TomBouthillet]

My pleasure.

[@SalmaAhmed-kt2nu]

Love it thank you!

[@TomBouthillet]

You are welcome, Salma Ahmed.

[@ReeceMedcalf92]

Thank you so much! 👍

[@TomBouthillet]

My pleasure, Reece!

[@otimpatrick3821]

Very informative.

[@kb2711]

What a great video. Please do one for LBBB as well. Better yet, please do a comprehensive series on ECG! :P

[@TomBouthillet]

Thank you, KB! I intend to do just that.

[@rahmanshaik8821]

Thank you.. good explanation

[@TomBouthillet]

Thank you, Rahman Shaik!

[@monalizaflores396]

thank you so much for your explanation ♥️♥️♥️♥️

[@TomBouthillet]

You're welcome, Monaliza!

[@dr.mukulkanojia]

Thank you so much Tom From India 🙏🏻

[@TomBouthillet]

You are welcome! Thank you for watching.

[@touseefbeig915]

Best. Thanks

[@jeanmulligan4168]

Thanks very useful

[@rafihatuel]

Thanks!

[@TomBouthillet]

You're welcome.

[@44529977]

the best explanation ever saw

[@TomBouthillet]

Thank you, Liane!

[@jancy197631]

Very informative

[@TomBouthillet]

Thank you, Jancy George!

[@Max-cz7kx]

Hi sory for my english, excelente video. I like to know on Ecg 24:10, is there a RBBB, but why on DI and aval is there a LBBB morphology? (Broad monophasic R wave), sometimes I see Thais, but o don't no why.

[@rajatkumardey9265]

Sir how do i say how greatful and lucky i am to learn and understand and apply the knowledge gained from you in my cardio EMR admissions, before i used to wait for senior doctor to confirm my diagnosis just to not make any misake while treating emergencies, now with your videos my concepts are much clear! and sir your comparisons with real life mistakes/misinterpret are real eye opener, like if it happened with other doctor then it can happen with us too unless everyone see your videos :)

[@TomBouthillet]

I appreciate your comment very much! Thank you, Rajat Kumar Dey.

[@saliha6767]

👏👏👏

[@bayanbaataropoo2510]

Please tell us what software was used to make this video...Please...Nice video

[@TomBouthillet]

Just PowerPoint recorded using ZOOM. Thank you for watching!

[@wagwag630]

Yeek, I have a right bundle branch block, left anterior fascicular block and bifascicular block. Can I make it through general anesthesia for a knee replacement?

[@TomBouthillet]

A lot of folks have a bifascicular block and it doesn't cause a problem. Others are high risk because they experience syncopal episodes or transient 3rd degree AV block. If you take oral antiarrhythmics, it might suppress the underlying escape rhythm. But this is why pre-op risk assessments take place. You should talk to your physicians about it.

[@alpaparaluisa431]

Sir, i have a complete right bundle branch block in my ECG result but my 2D echo with doppler came normal with mild mitral and tricuspid regurgitation. The doctor said it's normal and my heart is healthy. Should I worry about the "complete right bundle branch block"?

[@TomBouthillet]

I would try not to worry about something you can't change and your doctor isn't worried about.

[@alpaparaluisa431]

@@TomBouthillet thank you

[@tapanandachatterjee1118]

What is the treatment of Bifasicular block?

[@TomBouthillet]

Hi, Tapananda! It entirely depends on whether or not there are symptoms or the patient is deemed to be at significant risk of adverse events. Many patients have bifascicular block and it requires no treatment.

[@wilsondeguzman863]

😳😳😳😳😳

[@JulieMeikle]

Is there ever a false reading of RBBB?

[@TomBouthillet]

I suppose but it’s difficult to come up with a scenario. Why do you ask?

[@JulieMeikle]

@@TomBouthillet I have a report from September that states I have RBBB, LAFB and RVH. I've been researching and when I spoke to the heart institute the doctor said, I'm sure it's nothing.

[@JulieMeikle]

@@TomBouthillet From what I'm reading it's not nothing. I'm a good researcher by the way. :-) I don't scare very easy. I just want to understand what's happening with my body. I feel there is something wrong and doctors have this habit of saying, "oh, don't worry about it." I'm not a worrying, I just like knowledge.

[@JulieMeikle]

@@TomBouthillet I also want to say, thank you for your response. :-)

[@TomBouthillet]

Do you have a copy of the ECG? I’d be happy to offer an opinion of what it shows. I agree that bifascicular block is not “nothing.” I’m not entirely sure about the criteria for RVH in the setting of RBBB/LAFB but we can crowdsource an answer on Twitter with some heavy hitters if you like. @@JulieMeikle