The electrocardiographic diagnosis of ischemia/infarction in patients with right bundle branch block (RBBB) is not as difficult as it is in patients with left bundle branch block (LBBB) for two reasons:
- The initial portion of the QRS complex is not altered by the development of RBBB and
- the direction of the ST segment and T wave (i.e.the repolarization spatial vectors) in the setting of RBBB are quite similar to their direction in the absence of RBBB.