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In BBB, one ventricle contracts slightly later than the other, causing two “joined QRS’s to appear on the EKG
The diagnosis of BBB is based primarily on the width and appearance of the QRS. Ask these three questions.
1. Is the QRS wide (> 0.12 seconds)
2. Look for R and R’(prime) (only in V1 and V2 or V5 and V6)
3. Look on the right (V1 or V2) or left side (V5 and V6) of the heart.
This is generally accurate for the basic right and left bundle branch blocks.
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