Clinical analysis of right bundle branch block pattern for children and adults electrocardiogram

Abstract

Objective To analyze the age, etiologic distribution, combined type of block and the QRS wave width of electrocardiogram in children and adults with right bundle branch block (RBBB). Methods A total of 830 cases of outpatients and inpatients who were diagnosed as RBBB by electrocardiogram in Chengdu First People′s Hospital, West China Second Hospital of Sichuan University and West China Fourth Hospital of Sichuan University from January to December in 2013 were selected as the subjects. According to the age, they were divided into children group (n=330, all <18 years old) and adults group (n=500, all ≥18 years old). The age, etiologic distribution, combined types of blocks, QRS width of two groups were analyzed by statistical methods. Results ①The age of RBBB patients in children group was mainly distributed in 3 to 7 years old, accounting for 40.0% (132/330) of the total number of children group. The age of RBBB patients in adult group was mainly distributed in 50 to 70 years old, accounting for 40.8% (204/500) of the total number of adults group. ②Congenital heart disease was the most common cause of RBBB in children, preoperative and postoperative congenital heart disease patients accounted for 29.1% (96/330) and 56.4% (186/330), respectively in children group. Adults with chronic lung disease or a clear history of heart disease accounted for 65.6% (328/500) in adults group. ③The incidence of RBBB combined with other types of block in children group and adults group was 16.4% (54/330) and 50.4% (252/500), respectively. There was no significant difference in the constituent ratio of RBBB combined with other types of blocks in children and adults group (χ2=0.250, P=0.993). RBBB combined with left anterior branch block (LAFB) was the most common combined type of blocks both in adults and children group. ④The width of QRS in children with incomplete right bundle branch block (IRBBB) was (78.2±12.6) ms, which was lower than (98.9±9.3) ms in adults group, and the difference was statistically significant (t=-3.193, P=0.013). The QRS width of children with complete right bundle branch block (CRBBB) was (118.4±8.9) ms, which was significantly lower than (148.2±21.4) ms in adults group, and the difference was statistically significant (t=-3.214, P=0.012). Conclusions The distributions of RBBB in age, etiology, QRS width of electrocardiogram in children and adults are different. But there is no difference in the combination of other types of blocks betweeen children and adults with RBBB. Key words: Bundle branch block; Electrocardiography; Child; Adult