Medicines for Bundle branch block

What it is

Bundle branch block is a condition affecting the heart's electrical conduction system — the "wiring" that carries the electrical signal telling the heart to beat. The signal normally travels down two main pathways (the right and left bundle branches) to coordinate the contraction of the heart's lower chambers. In bundle branch block, one of these pathways is delayed or blocked, so the signal has to travel a slower route, and the chambers contract slightly out of sync. It is usually found on a heart tracing (ECG), often incidentally, rather than causing symptoms itself. There are two main types — right bundle branch block and left bundle branch block — and their significance differs. Right bundle branch block is often harmless and can occur in people with normal hearts. Left bundle branch block is more likely to be associated with an underlying heart condition (such as coronary artery disease, high blood pressure, or a problem with the heart muscle or valves), so it more often prompts assessment. In itself, bundle branch block frequently causes no symptoms and needs no direct treatment; its importance is mainly as a possible pointer to an underlying condition and, occasionally, as part of a broader conduction problem.

How it is treated

When bundle branch block is found, the approach is to consider what it might indicate rather than to treat the ECG finding itself, which usually needs no direct treatment. The doctor assesses the person's history, symptoms, and cardiovascular risk factors, and decides whether further evaluation is needed. Right bundle branch block in a person with no symptoms and no other concerns often needs no further action beyond noting it. Left bundle branch block, or bundle branch block with symptoms (such as breathlessness, chest pain, dizziness or fainting) or other ECG changes, more often leads to further assessment — which may include an echocardiogram (to look at the heart muscle and valves) and other tests, to check for an underlying heart condition that would then be managed on its own merits. Occasionally, bundle branch block is part of a more significant conduction disturbance affecting the heart rate, which may, if it causes symptoms, need treatment such as a pacemaker; and in some people with heart failure and left bundle branch block, a special type of pacemaker can help the heart pump more effectively. The reassuring message is that bundle branch block is often a harmless finding, particularly right-sided, but it is assessed because it can sometimes point to an underlying heart condition that benefits from identification and treatment.