RBBB classically shows an rsR' pattern in which lead?

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Multiple Choice

RBBB classically shows an rsR' pattern in which lead?

Right bundle branch block delays activation of the right ventricle, which alters the pattern of the QRS complex in leads that view the right side of the heart. The classic rsR' pattern—the small initial R, followed by a deeper S, and then a second positive deflection (R')—appears in the right precordial leads, most characteristically in V1. This occurs because the late activation of the right ventricle produces an additional R wave that stands out in a lead positioned over the right chest. In other leads such as V5, aVL, or II, the depolarization vectors are not oriented in a way that consistently produces this triphasic pattern, so the rsR' pattern is not the hallmark there. Therefore, the lead that best demonstrates this pattern is V1.

Right bundle branch block delays activation of the right ventricle, which alters the pattern of the QRS complex in leads that view the right side of the heart. The classic rsR' pattern—the small initial R, followed by a deeper S, and then a second positive deflection (R')—appears in the right precordial leads, most characteristically in V1. This occurs because the late activation of the right ventricle produces an additional R wave that stands out in a lead positioned over the right chest. In other leads such as V5, aVL, or II, the depolarization vectors are not oriented in a way that consistently produces this triphasic pattern, so the rsR' pattern is not the hallmark there. Therefore, the lead that best demonstrates this pattern is V1.

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