In addition to treating any underlying heart disease that may be present, treatment for bundle branch block (BBB) is generally not necessary unless the heart rate is too slow and fainting is present. In those circumstances, physicians may recommend surgery to implant an artificial pacemaker. Whether or not treatment is advised, people with BBB are encouraged to maintain regular contact with their physician to monitor for any unexpected cardiac changes.

A temporary pacemaker may also be necessary for certain cardiac procedures, such as cardiac catheterization. In this procedure, a long, thin catheter is guided into the heart to perform tests or other procedures. Patients with BBB are at risk for complete heart block in these circumstances, and temporary pacing is often recommended.

The best strategy for preventing BBB is to take preventive steps against the development of heart disease.

In patients who suffer from congestive heart failure due to a weakened heart muscle, the presence of a bundle branch block can further worsen the heart function. It is possible to improve the heart function by implantation of a cardiac resynchronising pacemaker. This works by correcting the abnormality in the timing of the contraction of the walls of the left ventricle. This preventative measure can relieve the symptoms of congestive heart failure.