Right Bundle Branch Block (RBBB)

Consideration

Incomplete RBBB is common, being seen in 2-3 % of routine ECGs. It has no negative prognostic features. It is considered to be a normal variant of no aeromedical significance.

Complete RBBB is seen much less frequently. It has a good prognosis provided that ischaemia has been excluded and there is no associated cardiac abnormality or atrioventricular block.

Information to be provided

On the first occasion that an applicant presents with a RBBB a cardiologist report to include:

• The result of an echocardiogram;
• A stress ECG if the applicant is aged 45 years old or above, or if required under the General Directions, or as clinically indicated.

On subsequent occasions:

• Routine investigations as prescribed by the General Directions, provided no change to the ECG has occurred;
• A cardiologist report if a change to the ECG has occurred.

Disposition

On the first occasion that an applicant presents with an RBBB, that applicant may be considered as having a condition that is not of aeromedical significance if:

• No myocardium anatomy abnormality has been identified;
• There is no AV block;
• Ischaemia has been excluded by stress testing if the applicant is 45 years old or above, or if required under the General Directions, or as clinically indicated.

On subsequent occasions that an applicant presents with an RBBB, that applicant may be considered as having a condition that is not of aeromedical significance if:

• The ECG has not changed;
• The applicant’s cardiovascular risk estimate is assessed as being acceptable under the GD.