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Bundle branch block

MedGen UID:
2752
Concept ID:
C0006384
Disease or Syndrome; Finding
Synonyms: Block, Bundle Branch; Block, Bundle-Branch; Blocks, Bundle Branch; Blocks, Bundle-Branch; Branch Block, Bundle; Branch Blocks, Bundle; Bundle Branch Block; Bundle Branch Blocks; Bundle-Branch Block; Bundle-Branch Blocks
SNOMED CT: Bundle branch block (6374002); BBB - Bundle branch block (6374002)
 
HPO: HP:0011710

Definition

Block of conduction of electrical impulses along the Bundle of His or along one of its bundle branches. [from HPO]

Conditions with this feature

Brugada syndrome 5
MedGen UID:
411607
Concept ID:
C2748541
Disease or Syndrome
Brugada syndrome is characterized by cardiac conduction abnormalities (ST segment abnormalities in leads V1-V3 on EKG and a high risk for ventricular arrhythmias) that can result in sudden death. Brugada syndrome presents primarily during adulthood, although age at diagnosis may range from infancy to late adulthood. The mean age of sudden death is approximately 40 years. Clinical presentations may also include sudden infant death syndrome (SIDS; death of a child during the first year of life without an identifiable cause) and sudden unexpected nocturnal death syndrome (SUNDS), a typical presentation in individuals from Southeast Asia. Other conduction defects can include first-degree AV block, intraventricular conduction delay, right bundle branch block, and sick sinus syndrome.
LEOPARD syndrome 1
MedGen UID:
1631694
Concept ID:
C4551484
Disease or Syndrome
Noonan syndrome with multiple lentigines (NSML) is a condition in which the cardinal features consist of lentigines, hypertrophic cardiomyopathy, short stature, pectus deformity, and dysmorphic facial features including widely spaced eyes and ptosis. Multiple lentigines present as dispersed flat, black-brown macules, mostly on the face, neck, and upper part of the trunk with sparing of the mucosa. In general, lentigines do not appear until age four to five years but then increase to the thousands by puberty. Some individuals with NSML do not exhibit lentigines. Approximately 85% of affected individuals have heart defects, including hypertrophic cardiomyopathy (typically appearing during infancy and sometimes progressive) and pulmonary valve stenosis. Postnatal growth restriction resulting in short stature occurs in fewer than 50% of affected persons, although most affected individuals have a height that is less than the 25th centile for age. Sensorineural hearing deficits, present in approximately 20% of affected individuals, are poorly characterized. Intellectual disability, typically mild, is observed in approximately 30% of persons with NSML.

Professional guidelines

PubMed

Strasburger JF, Eckstein G, Butler M, Noffke P, Wacker-Gussmann A
J Clin Pharmacol 2022 Sep;62 Suppl 1(Suppl 1):S53-S66. doi: 10.1002/jcph.2129. PMID: 36106782Free PMC Article
Verdonschot JAJ, Hazebroek MR, Krapels IPC, Henkens MTHM, Raafs A, Wang P, Merken JJ, Claes GRF, Vanhoutte EK, van den Wijngaard A, Heymans SRB, Brunner HG
Circ Genom Precis Med 2020 Oct;13(5):476-487. Epub 2020 Sep 3 doi: 10.1161/CIRCGEN.120.003031. PMID: 32880476
Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ, Lee R, Marine JE, McLeod CJ, Oken KR, Patton KK, Pellegrini CN, Selzman KA, Thompson A, Varosy PD
Circulation 2019 Aug 20;140(8):e382-e482. Epub 2018 Nov 6 doi: 10.1161/CIR.0000000000000628. PMID: 30586772

Recent clinical studies

Etiology

Gilge JL, Padanilam BJ
Cardiol Clin 2023 Aug;41(3):393-397. doi: 10.1016/j.ccl.2023.03.011. PMID: 37321689
Gilge JL, Padanilam BJ
Card Electrophysiol Clin 2021 Dec;13(4):685-689. Epub 2021 Sep 23 doi: 10.1016/j.ccep.2021.06.008. PMID: 34689895
Tan NY, Witt CM, Oh JK, Cha YM
Circ Arrhythm Electrophysiol 2020 Apr;13(4):e008239. Epub 2020 Mar 18 doi: 10.1161/CIRCEP.119.008239. PMID: 32186936
Alventosa-Zaidin M, Roca Saumell C, Brugada Terradellas J
Med Clin (Barc) 2018 Nov 21;151(10):402-411. Epub 2018 Aug 20 doi: 10.1016/j.medcli.2018.04.026. PMID: 30139583
Surkova E, Badano LP, Bellu R, Aruta P, Sambugaro F, Romeo G, Migliore F, Muraru D
Europace 2017 Aug 1;19(8):1251-1271. doi: 10.1093/europace/eux061. PMID: 28444180

Diagnosis

Lustgarten DL, Habel N, Sánchez-Quintana D, Winget J, Correa de Sa D, Lobel R, Thompson N, Infeld M, Meyer M
Heart Rhythm 2024 Sep;21(9):1711-1717. Epub 2024 Mar 27 doi: 10.1016/j.hrthm.2024.03.1786. PMID: 38552731
Gilge JL, Padanilam BJ
Cardiol Clin 2023 Aug;41(3):393-397. doi: 10.1016/j.ccl.2023.03.011. PMID: 37321689
Ikeda T
Curr Cardiol Rev 2021;17(1):24-30. doi: 10.2174/1573403X16666200708111553. PMID: 32640959Free PMC Article
Tan NY, Witt CM, Oh JK, Cha YM
Circ Arrhythm Electrophysiol 2020 Apr;13(4):e008239. Epub 2020 Mar 18 doi: 10.1161/CIRCEP.119.008239. PMID: 32186936
Strauss DG, Selvester RH, Wagner GS
Am J Cardiol 2011 Mar 15;107(6):927-34. doi: 10.1016/j.amjcard.2010.11.010. PMID: 21376930

Therapy

Vijayaraman P, Pokharel P, Subzposh FA, Oren JW, Storm RH, Batul SA, Beer DA, Hughes G, Leri G, Manganiello M, Jastremsky JL, Mroczka K, Johns AM, Mascarenhas V
JACC Clin Electrophysiol 2023 Dec;9(12):2628-2638. Epub 2023 Sep 13 doi: 10.1016/j.jacep.2023.08.003. PMID: 37715742
Wang Y, Zhu H, Hou X, Wang Z, Zou F, Qian Z, Wei Y, Wang X, Zhang L, Li X, Liu Z, Xue S, Qin C, Zeng J, Li H, Wu H, Ma H, Ellenbogen KA, Gold MR, Fan X, Zou J; LBBP-RESYNC Investigators
J Am Coll Cardiol 2022 Sep 27;80(13):1205-1216. doi: 10.1016/j.jacc.2022.07.019. PMID: 36137670
Vijayaraman P, Chung MK, Dandamudi G, Upadhyay GA, Krishnan K, Crossley G, Bova Campbell K, Lee BK, Refaat MM, Saksena S, Fisher JD, Lakkireddy D; ACC’s Electrophysiology Council
J Am Coll Cardiol 2018 Aug 21;72(8):927-947. doi: 10.1016/j.jacc.2018.06.017. PMID: 30115232
Strauss DG, Selvester RH, Wagner GS
Am J Cardiol 2011 Mar 15;107(6):927-34. doi: 10.1016/j.amjcard.2010.11.010. PMID: 21376930
Lancet 1994 Feb 5;343(8893):311-22. PMID: 7905143

Prognosis

Sammour Y, Krishnaswamy A, Kumar A, Puri R, Tarakji KG, Bazarbashi N, Harb S, Griffin B, Svensson L, Wazni O, Kapadia SR
JACC Cardiovasc Interv 2021 Jan 25;14(2):115-134. doi: 10.1016/j.jcin.2020.09.063. PMID: 33478630
Payne J, Garlitski AC, Weinstock J, Homoud M, Madias C, Estes NAM
J Interv Card Electrophysiol 2018 Aug;52(3):323-334. Epub 2018 Aug 13 doi: 10.1007/s10840-018-0412-5. PMID: 30105429
Chioncel O, Lainscak M, Seferovic PM, Anker SD, Crespo-Leiro MG, Harjola VP, Parissis J, Laroche C, Piepoli MF, Fonseca C, Mebazaa A, Lund L, Ambrosio GA, Coats AJ, Ferrari R, Ruschitzka F, Maggioni AP, Filippatos G
Eur J Heart Fail 2017 Dec;19(12):1574-1585. Epub 2017 Apr 6 doi: 10.1002/ejhf.813. PMID: 28386917
Massoullié G, Bordachar P, Ellenbogen KA, Souteyrand G, Jean F, Combaret N, Vorilhon C, Clerfond G, Farhat M, Ritter P, Citron B, Lusson JR, Motreff P, Ploux S, Eschalier R
Am J Cardiol 2016 Mar 1;117(5):867-73. Epub 2015 Dec 13 doi: 10.1016/j.amjcard.2015.12.009. PMID: 26742470
Kim JH, Baggish AL
J Electrocardiol 2015 May-Jun;48(3):380-4. Epub 2015 Mar 14 doi: 10.1016/j.jelectrocard.2015.03.015. PMID: 25836379

Clinical prediction guides

Bendandi F, Taglieri N, Ciurlanti L, Mazzapicchi A, Foroni M, Lombardi L, Palermo F, Filice F, Ghetti G, Bruno AG, Orzalkiewicz M, Costa G, Frittitta V, Comis A, Sammartino S, Calì MC, Dipietro E, Rosa L, Tamburino C, Palmerini T, Barbanti M, Saia F
EuroIntervention 2025 Jan 20;21(2):e119-e129. doi: 10.4244/EIJ-D-24-00850. PMID: 39570035Free PMC Article
Alventosa-Zaidin M, Pera G, Roca Saumell C, Mengual Miralles N, Zamora Sanchez MV, Gros Garcia T, Guix Font L, Benitez Camps M, Francisco-Pascual J, Brugada Terradellas J
BMC Fam Pract 2019 May 6;20(1):58. doi: 10.1186/s12875-019-0946-3. PMID: 31060516Free PMC Article
Brodov Y, Konen E, Di Segni M, Samoocha D, Chernomordik F, Barbash I, Regev E, Raanani E, Guetta V, Segev A, Fefer P, Glikson M, Goitein O
Circ Cardiovasc Imaging 2019 Dec;12(1):e007508. doi: 10.1161/CIRCIMAGING.117.007508. PMID: 30636515
Surkova E, Badano LP, Bellu R, Aruta P, Sambugaro F, Romeo G, Migliore F, Muraru D
Europace 2017 Aug 1;19(8):1251-1271. doi: 10.1093/europace/eux061. PMID: 28444180
Russell K, Eriksen M, Aaberge L, Wilhelmsen N, Skulstad H, Remme EW, Haugaa KH, Opdahl A, Fjeld JG, Gjesdal O, Edvardsen T, Smiseth OA
Eur Heart J 2012 Mar;33(6):724-33. Epub 2012 Feb 6 doi: 10.1093/eurheartj/ehs016. PMID: 22315346Free PMC Article

Recent systematic reviews

Yu GI, Kim TH, Cho YH, Bae JS, Ahn JH, Jang JY, Kwak CH
Pacing Clin Electrophysiol 2025 Jul;48(7):682-690. Epub 2025 May 23 doi: 10.1111/pace.15209. PMID: 40407354
El Iskandarani M, Golamari R, Shatla I, Ujueta F, Mihos CG, Escolar E, Elajami TK, Weiss R
J Cardiovasc Electrophysiol 2024 Aug;35(8):1536-1547. Epub 2024 May 29 doi: 10.1111/jce.16304. PMID: 38812213
Parlavecchio A, Vetta G, Caminiti R, Coluccia G, Magnocavallo M, Ajello M, Pistelli L, Dattilo G, Foti R, Carerj S, Della Rocca DG, Crea P, Palmisano P
Pacing Clin Electrophysiol 2023 May;46(5):432-439. Epub 2023 Apr 10 doi: 10.1111/pace.14700. PMID: 37036831
Zhong C, Xu W, Shi S, Zhou X, Zhu Z
Pacing Clin Electrophysiol 2021 Mar;44(3):497-505. Epub 2021 Feb 1 doi: 10.1111/pace.14174. PMID: 33491220
Alventosa-Zaidin M, Roca Saumell C, Brugada Terradellas J
Med Clin (Barc) 2018 Nov 21;151(10):402-411. Epub 2018 Aug 20 doi: 10.1016/j.medcli.2018.04.026. PMID: 30139583

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