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February 28, 1977

Questions and Answers

JAMA. 1977;237(9):901-902. doi:10.1001/jama.1977.03270360063025

How Important Is Complete Right Bundle-Branch Block in Asymptomatic 60-Year-Old Man?  Q An ECG finding of a complete right bundle-branch block (RBBB) was first noted six years ago in an otherwise asymptomatic man who is now 60 years of age. A normal QRS interval was noted on ECGs done in the next two years, but at his most recent examination, the RBBB pattern was again present. There has been no heart rate variation to suggest that the block is rate related. No other studies have been done in this patient because of his asymptomatic state. Does your consultant think coronary arteriography is indicated? What is the cause of this condition?Harry C. Mack, MDToledo, OhioA The finding of complete RBBB in a totally asymptomatic person is always viewed with some interest and only rarely with concern. Many of the clinical studies noted in the literature dealing with prognosis