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Cohort study of Copenhagen on idiopathic RBBB

Resolved Question:

(34 YR OLD, healthy and no symptoms)

The cohort study of coppenhagen city has determined that rbbb is not so benign or innocent in the absence of underlying cause. Please advise if this study is reliable and does it negate all previous studies. Is my complete asymptomatic RBBB (as told to me by cardio doc) now not benign at all and with bad prognosis as per the new coppenhagen study ??

When we speak of a mortality risk of increase of 36 % how is that calculated ? Is there a chance that longevity will not be affected?

Please let me know what do you think is the QRS value as per the attached ecg.

Please refer to attached ecg done yesterday and provide me with your medical feedback.

The doctor said that the results of my previous ecg done 5 years ago are very similar.

Thanking you.

Category: Cardiologist

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Category: Cardiologist
 31 Doctors Online

Hello
Thank you for your query at doctorspring.com.

Vast majority of studies have found rbbb as innocuous. Now in light of this study new onset rbbb may be a marker if degenerative changes and may indicate increased mortality frim cv causes.

But your case doesn't exactly fit into the study population as you already had a rbbb at young age and is likely to be a congenital one right from birth.
The study couldn't conclude that the rbbb in young is dangerous enough.
If you are free of any structural heart disease and risk factors I don't think you should be worried.

But you should now on be extra cautious given the doubts that this study has put in our minds and take care of diet and exercise to avoid any such possible risk. its a single study which says so and the best you can do is take it seriously enough to modify your lifestyle to a healthy one.

Hope this helps, please feel free to discuss further.

Regards
Dr Vivek Mahajan
DM Cardiology



Patient replied :

What is the QRS value exactly is it 125 or more than that in your opinion ? Other than rbbb does everything else seem normal ? Thanks


Hello
From what is apparent and subject to limitations of camera resolution the qrs apoears to be slightly over 120ms and definitely less than 160 ms.
Apart from rbbb I do not see any other abnormality


Regards
Dr Vivek Mahajan


Patient replied :

How can I stop being so worried. Are there good percentage of people with similar ecg results (complete rbbb)and same condition who have lived a normal life span and continued to exercise and with no effect on longetivity ? Should I keep exercising and playing tennis and running as long as there are no symptoms ? Will exercise in my case widen the qrs even more ?? Thanks


Hello
Please do not be worried. Even if they say that risk is increased the study is done in a different subset of patients who have acquired rbbb recently, unlike you. Just follow a healthy lifestyle with exercise and all should be well. Practice relaxation techniques and leave all worries as the risk is small and only thing you can do is to lead a healthy lifestyle.


Regards
Dr Vivek Mahajan
DM Cardiology


Patient replied :

There is a big difference between QRS= 120 and QRS= 160. Do you think from what is apparent that the QRS is closer to 120 than 130. One doctor told me that the QRS appears to be almost exactly 120 and another doctor told me its over 130. What is the correct figure in your opinion.

Also, i was very anxious when i took the test and my heart rate was 92 when in fact usually it is in the 50s and 70 s when im sitting or lying . Does the elevated heart rate during ecg has an effect on widening the QRS ??? thanks


Hello,
The ecg uploaded by you is limited by your camera resolution and it is not possible to tell. But it appears slightly more than 120 and less than 160. Anyhow it doesn't matter how much it is. The risk of rbbb is itself doubtful.

The significance of duration is even more doubtful. At higher rates qrs may tend to widen in some patients with rbbb. Again the significance of this rate related bundle branch bkock is unknown or not strongly established.

Hope this helps. Regards


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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