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Cardiac Rehabilitation

Understanding an IRBBB



Today I was diagnosed with IRBBB during a stress test. Another doctor in my doctor`s office did the test at my doctor`s request, after I came in regarding my blood pressure. My doctor did not mention it when he did an EKG when I initially came in a week ago. My systolic has always been alright (110-130), whereas my diastolic has always been high (85-95). A few years ago I began taking Toprol for it and it seemed to work, lowering my diastolic to around 70-75. Recently, however, it has returned to being high (85-95). The same time I started Toprol I started taking Paroxetine for anxiety. So, really it is impossible to determine if it was the Toprol lowering it directly or the Paroxetine lowering it indirectly. I suspect the Toprol didn`t lower it, since my BP went back up about the time I stopped taking Paroxetine. I also am on cholesterol medication (Crestor). My levels are alright since I have been on it. Does this information suggest anything to you?


An IRBBB during a stress test is a nonspecific finding in and of itself. It is hard to say if this is something new, or if you had a IRBBB on a previous ECG, without a prior ECG to compare it to. Even if it developed with exercise, it is a common finding when the heart rate increases. Perhaps you could discuss it with your doctor to see if this is something that was seen on prior resting ECG's.

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Response by:

Karen   Kutoloski, DO Karen Kutoloski, DO
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University