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Diagnosed with incomplete right bundle branch block. Scheduled for spinal fusion. Found RBBB complete. Suggest?

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Practicing since : 1998
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I am a 42 year old male. About a year ago my cardiologist diagnosed me with an incomplete right bundle branch block.I was scheduled to have a spinal fusion as I have had 3 back surgeries and I am in constant pain. I was required to go back to my cardiologist to make sure I would okay for the surgery. She discovered that my RBBB is now complete. Can you tell me what may be going on? I do have rapid heart beat and have been taking Tenormin for many years. Thank you.

I am required to have a nuclear stress test in a couple of weeks before I will know for sure I can safely have the surgery. I do have some chest pain and minor shortness of breath but not often. The rapid heart beat is always "around".
Posted Sat, 12 Oct 2013 in Heart Rate and Rhythm Disorders
Answered by Dr. Sukhvinder Singh 27 minutes later
Brief Answer:
please see details.

Detailed Answer:
Dear Sir
1. Complete or incomplete right bundle branch block is an electrical phenomenon. If it is present alone (as it seems to be in your case), it does not represent any disease in itself. It may be a normal variant or may indicate an underlying heart condition. The best way to rule out a heart condition in such cases is to get an ultrasound of heart and rule out structural abnormalities. If you had an ECHO or cardiac ultrasound (after developing right bundle branch block) and no structural heart disease was there beside "mitral valve prolapse", then it is more likely to be benign entity.
2. In most of the patients where the right bundle branch block is not associated with a structural abnormality & it is the only electrical block (isolated block), it represent aging or degeneration. This is usually a benign entity.
3. You are being subjected to nuclear stress test , not for the evaluation of the right bundle branch block but for assessment of coronary artery disease (anginal heart disease) prior to surgery.
Hope this provides some insight.
Feel free to discuss further.
Above answer was peer-reviewed by
Follow-up: Diagnosed with incomplete right bundle branch block. Scheduled for spinal fusion. Found RBBB complete. Suggest? 2 hours later
Is the changing from incomplete to complete RBBB normal or an indication of something more? Thank you.
Answered by Dr. Sukhvinder Singh 2 minutes later
Brief Answer:
Please see below.

Detailed Answer:
Dear sir,
This depends upon the underlying cause. If it is degenerative or age related it is bound to happen with time. Still if you do not have any symptom because of it and there is no other block in ECG, nothing is to be done.
If it is associated with a structural heart disease (on ECHO), it may indicate progression of the disease.
Hope this clarifies the issue. Please do write if there is anything else.
Above answer was peer-reviewed by
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