Right Bundle Branch Block in 11 year old child

[KarenSA]

My son is 11 years old and was recently diagnosed with RBBB in isolation.  I do not know if it is complete or incomplete, it does come through on every beat.  He has no symptoms and was only diagnosed because I took him for cardiac screening due to high intensity sport training and competition which he participates in - swimming.  He had a stress test and got his heart up to 101% capacity and really coped very well, he did not want to stop running on the treadmill he was enjoying it so much.  His cardiologist cleared him to swim and advised that we do not even need to inform his coach.  He will go for an annual check up though.  I (his mom) have a history of symptomatic PVC's, PAC's and had a successful ablation for Atrial Tach and Atypical AVNRT a year ago.  He trains about 3.5km daily in the pool in about 1.5 hours.  He races galas regularly and he also participates in open water swimming and then races 1 mile as fast as he can manage.  
My concern is how safe is it for him to be out in the middle of a dam in an open water event with RBBB. What is the incidence of RBBB in the normal population and is it true that RBBB in isolation can be regarded as a normal variant and that he can continue to participate in high intensity sport - particularly in water?  Also, athlete heart syndrome and RBBB - given the amount of training he does, I would expect that perhaps his heart will enlarge, will this be safe with underlying RBBB?
Thank you very much for your very valued response.  Karen

[geeksprincess]

i am 18yrs old and was diagnosed last yr with a RBBB.  i am very athletic playing soccer and lacrosee and also being an EMT.  i have not had a problem yet, they only reason they found it is b/c a medic student was practicing EKG's on me and saw something.  if your doctor said he is fine to swim and work out than leave him be active.  good luck!

[momto3girls]

Hey there,

Let's see...I don't remember exactly how my dad found out.  I just remember him saying he's had the RBBB since he was an early teen. I understand what you mean about taking your child to the doctor and expecting everything to be normal...my 5 year old daughter gave us a scare when I took her in for a check-up this summer and the pediatrician (prematurely) mentioned something about cystic fibrosis.  I barely slept until they ruled it out.  We always want our children to be strong and healthy and when, even for a split second, something contrary happens, we panic.  I think it's an extremely normal response and shows how much love and concern we have for our kids (:

Again, I think it's so wonderful that son is dedicated and active in sports.  I have a younger brother who would rather play Sony playstation and watch Office Space for the 100th time rather than exercise!  

I've read in several places on the internet that people with RBBB and are asymptomatic, it's not a big deal and it's more of just an incidental finding on an ekg.  Good luck and best wishes to you and your son (:

[KarenSA]

Thanks for telling me about your Dad too.  I was pleased to see he was diagnosed as a teen (how did they pick it up?)and continued an active sporting life.  Although the cardio assured me it was not a worry and I was the one who decided to have him screened because of my history, I was not prepared for the outcome.  You kind of just assume that all is normal because on the surface it looks like it. It has taken a little getting used to and a bit of research to put me more at ease.  My son is not in the least bit bothered as I have made light of it, so it looks like we can forget about the screening and get on with life, apart from the annual stress test. Regards Karen

[KarenSA]

Thanks for letting me know about your Dad.  It is good to hear of others with rbbb who are asymptomatic and active sports people.

[KarenSA]

I don't know if you go back and perhaps read comments after answering a post, but I just want to say thank you very much for giving me some more peace of mind.

[momto3girls]

Hi there,

My dad has had RBBB since he was a teen.  He participated in all kinds of sports in high school.  Actually he broke his arm on the gymnastics rings, he wasn't too coordinated (:  I won't tell you how he did playing hockey!  LOL!  I remember going to his games as a little girl and cheering my heart out, even though he spent probably more time falling down than skating! I can definitely pin my uncoordinatedness on him, bless his heart.

Anyhow, he's been asymptomatic with it for as long as it's been know he has it.  I understand your concern though...I have children too and that would raise concern if I were in your shoes.  Great for your son to be so stinking active!  I wish I had that kind of stamina (:  Imagine what I could get done in one day!  Good luck to your son and best wishes!

Sincerely,
momto3girls

[KarenSA]

Hi.  The way I understand rbbb is that the impulse travelling from the atria down to the ventricles to stimulate them to beat, is blocked on the right hand side so it does not trigger the right ventricular beat.  In this case then the right ventricle picks up its signal to beat from the contraction of the left ventricle.  As a result the right ventricle beats milliseconds after the left ventricle.  The heart sound then becomes a 'lub dub dub' instead of just the normal 'lub dub'.

[KarenSA]

Hi.  Thanks for the positive comments!  I agree, some children do spend too much time in front of TV's and computers.  The cardio had never had a patient who he could not get off the treadmill and who was 'racing' himself - time running versus distance covered. Eventually I had to tell him firmly that it was time to give the treadmill back!  Regards.

[englishlad]

im curious...what is rbbb?

[anacyde]

Hearing about an 11 year old who *wants* to run a treadmill and exercise gives me a happy feeling.  So many kids sit and do nothing but play video games.  I really hope everything is good for your son so he can continue to be active and healthy.  Sounds like a pretty cool kid :)

[PikaPika88]

I was a basket ball player when I was young.  When I was 15, diagnosed with RBBB and WPW.  When the pacemaker pacing at the right sides of my heart, it shows LBBB.  The time I was 36, my pacer failed so I ended up with a complete heart block.  My HIS bundle ablated at the age of 27.  Sorry, it is a bit confusing.  I wish I could help.

Pika

[momto3girls]

RBBB stands for right bundle branch blockage.  My dad actually has a RBBB.  It has to do with the "his bundle" that runs down the middle of your heart, like a nerve pathway that the electrical impulses travel.  (My dad's ekg was very obvious for his RBBB, it looked like giant waves.)  The impulses stimulate the left and right ventricles.  Basically it is the flow of electricity through the heart. That's my take on it anyhow, I sure as heck am not a doctor!  Hope that makes sense (:

[CCF-M.D.-MJM]

Hi Karen,

Your doctors is correct that people with an asymptomatic right bundle branch on EKG have perfectly normal prognosis.  There is data on screening military personal with EKGs and the incidence of asymptom right bundle branch block in people less than 30 years old is 0.2%.  From what you have told me it sounds like there is no problem with him competing in high intensity athletics.  It is reasonable to have yearly physical exams, but I do not think you should worry about this.  

I hope this answers your questions.  Good luck and thanks for posting.