pvc's RBBB

[Chuck1000]

I have had pvc's off and on for years. I have now shown RBBB on an EKG, and sometimes while having pvc's have bradycaria. My doctors say all is ok, and I have has all kinds of tests. Is there an explanation or relationship between all this?

[Chuck1000]

It turns out I also have a thyroid problem, Hashimoto's. That could be involved.

[CHELLETO6DOGS]

I just typed this question RIGHT BUNDLE BRANCH BLOCK AND PVC'S into my computer and this is what appeared for a goolge first part ia the question


Incomplete Right bundle branch block and PVCs/PACs
by Bossa, Dec 29, 2003 12:00AM
Tags: incomplete, block, palpitation, Heart, Anxiety, frequency, premature
Thank you for taking my question(s). I am a healthy 27 year old male and I was diagnosed with IRBBB about 4 years ago during a routine physical, since then I have been experiencing PVCs and PACs every so often.  For the last eight months I am getting them daily, usually three to four times per day.  Could the IRBBB be causing these PVCs or is it simply my anxiety over my "heart condition"?  Should I be concerned over the increase in frequency of my PVCs and PACs?

I really don't want to take any medication if I don''t have to and I heard and read about Chinese herbs, with no side effects, that are very successful in supressing PVCs.  Has anyone else tried or even heard about that?  I

My doctor says my heart is fine.  I have had numerous EKGs and my heart is sound.  I also wore a holter, but nothing showed up on it over that 24hr span (murphy's law at it's best).  So I am relentless in curing these annoying, frightful and distracting PVCs, even of they are benign in nature.

Any suggestions?
  
This forum has been great help and I would like to thank all of you!
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AND NOW THE ANSWER FROM THE DOCTOR HOPE THIS HELPS


by CCF-M.D.-RCJ, Dec 29, 2003 12:00AM
Bossa,

Thanks for the post.

Q1:"Could the IRBBB be causing these PVCs or is it simply my anxiety over my "heart condition"?

Neither.  IRBBB is not mechanistically related to premature beats, be they from the atrium (PAC) or ventricle (PVC).  Anxiety, by raising adrenaline levels, can increase the frequency of premature beats in a minority of persons.  And notice that I use the term "persons", and not "patients".

Q2:"Should I be concerned over the increase in frequency of my PVCs and PACs?"

If you mean to ask if I think that these PACs or PVCs will kill or hurt you, then No, I think that you will suffer no ill physical effects from these premature beats.  However, anxiety about these beats can be disabling, and needs treatment.

Q3:"I heard and read about Chinese herbs, with no side effects ..."

Really, like Mua Huang, which leads to an increased incidence of strokes.  I believe that there is a legitimate, albeit limited, role for diet supplements and alternative medicines.  But I implore you to use common sense.  Do you really think that the Chineese have somehow concocted effective therapeutic potions devoid of side effects?  I'll be the first in line to use and prescribe them the day I see a shred of proof.

One last bit on info about IRBBB.  A 1975 study of 237,000 airmen under age 30 found 394 cases of complete RBBB, representing an incidence of 0.2 percent.  Ninety four percent of these subjects had a normal cardiovascular examination and the course was benign, with only one subject requiring a pacemaker in 10 years.  Presumably, IRBBB would be even more benign.

Happy Holidays.
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I HOPE THIS HELPS YOU WITH YOUR QUESTION
MICHELLE

[CHELLETO6DOGS]

sorry I hit the ENTER button instead of space bar.  sorry.
anyways so i guess to answer part of your question brady can happen with RBBB
michelle

[CHELLETO6DOGS]

I am not sure if this helps or not. I have a 6 year old who has a complete RBBB. he does brady down a lot, however they say it isn't anything to be concerned of, however nothing mentioned about PVC's he also does have a high HR at times normal for him while active is about 150 and his goes over 200 but with the complete RBBB it is hard to see if he really is having VT or not. he has what is called an implantable loop recorder, something like a holter but implanted.

[itdood]

Chuck1000:  Brady can enhance conditions that lead to PVCs.  I'm not aware of RBBB directly causing ectopic beats like a PVC.  I can't even think of a way that the 2 are directly related.  Has it been documented on an EKG that you had RBBB and PVCs at the same time?   I think RBBB might feel a bit like a PVC due to the conduction delays in the ventricles, essentially the left and right ventricle won't contract at the same time like they're supposed to so it may feel like a flutter (i'm not sure).

jonesy2:  "most benign PVCs originate from the LBBB (left Bundle Block Branch)"

I just wanted to clarify this a bit.  Are you referring to LBBB as a structure of the heart?  That's how I'm reading it.  If so, that's not the case.  LBBB describes a conduction problem with the AV node.  The Left branch will block a beat signal.  But, the right ventricle still receives the signal.  This leads to a wide QRS I thought.  It's impossible for LBBB to trigger a PVC.  To the contrary LBBB blocks a beat.  I could be reading this wrong, sorry if I am.

[jonesy2]

All I know is that most benign PVCs originate from the LBBB (left Bundle Block Branch) and the Right ventricular Outflow Tract.

It does not sound like anything sinister to me. Provided you have a structurally normal heart, you can be reassured they are of a benign nature.

Only if you strat getting more than 4000 a day will they normally try more aggressive treatments, including betablockers, and potentially ablation. I had an ablation and my pvcs have reduced from 16000 a day to single digits.

best of luck.  

Jonesy 2