Professional and Linguistic Assessments Board (PLAB) Practice Exam

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Which arrhythmia is typically identified by the presence of 'bunny ears' in lead V1-V3 on an ECG?

Left Bundle Branch Block (LBBB)
Right Bundle Branch Block (RBBB)
Atrial Fibrillation
Ventricular Fibrillation

The correct answer is: Right Bundle Branch Block (RBBB)

The presence of "bunny ears" in leads V1-V3 on an ECG is characteristic of Right Bundle Branch Block (RBBB). In RBBB, the electrical impulse is delayed in the right bundle branch of the heart's conduction system, which leads to a specific pattern on the ECG. When analyzing the waveforms, RBBB manifests as a distinctive "M" shape or "bunny ears" in the QRS complexes, particularly visible in the precordial leads. This pattern results from the delayed depolarization of the right ventricle, creating a secondary R wave and leading to the characteristic appearance that resembles bunny ears. Understanding the morphology of the QRS complexes in different arrhythmias is crucial for accurate diagnosis and management. In contrast, Left Bundle Branch Block (LBBB) produces a different pattern, typically a wide, slurred R wave with a deep S wave in leads V1-V3, and does not present the "bunny ear" appearance. Atrial Fibrillation and Ventricular Fibrillation have distinct health implications and morphologies that do not resemble the pattern associated with RBBB.