Lafb ecg

• Electrocardiogram (ECG or EKG). This quick and painless test measures the electrical activity of the heart. During an ECG, sensors (electrodes) are attached to the chest and sometimes to the arms or legs. An ECG can show how well the heart is beating. It can show signs of a bundle branch block, as well as which side of the heart is being affected. • Echocardiogram. This test uses sound waves to provide detailed images of the heart and heart valves. It can show the structure and the thickness of the heart muscle. Your provider can use this test to pinpoint a condition that caused the bundle branch block. Treatment Most people with bundle branch block don't have symptoms and don't need treatment. For example, left bundle branch block is not treated with medications. However, treatment depends on the specific symptoms and other heart conditions. Medications If you have a heart condition causing bundle branch block, treatment might involve medications to reduce high blood pressure or reduce symptoms of heart failure. Surgeries and other procedures If you have bundle branch block and a history of fainting, your health care provider might recommend a pacemaker. A pacemaker is a small device implanted under the skin of the upper chest. Two wires connect it to the right side of the heart. The pacemaker releases electrical impulses when needed to keep the heart beating regularly. If you have bundle branch block with low heart-pumping function, you may need cardiac resynchronizati...

Clinically, bifascicular block presents with one of two ECG patterns: • Right bundle branch block ( • RBBB and left posterior fascicular block ( * Some authors describe Left bundle branch block ( LBBB) as a bifascicular block, as it may indicate LAFB + LPFB. However, clinically the term bifascicular block is reserved for RBBB with either LAFB or LPFB Electrophysiology Bifascicular block involves conduction delay below the atrioventricular node in two of the three fascicles: • Conduction to the ventricles is via the single remaining fascicle • The ECG will show typical features of RBBB plus either left or right axis deviation. • RBBB + LAFB is the most common of the two patterns. This is due to a single coronary artery blood supply (LAD) to the anterior fascicle • RBBB + LPFB is less common due to a dual blood supply (right and left circumflex arteries), and this combination may be associated with more extensive underlying cardiac pathology Clinical significance Bifascicular block is often associated with structural heart disease (50-80%) and extensive fibrosis of the conducting system. There is a risk of progression to complete heart block with additional damage to the third remaining fascicle, however clinical context is important: • Overall rate of progression to complete heart block is 1-4% per year • In symptom free patients, these figures are ~1% per year • Patients presenting with syncope have a 17% annual risk of progression • Syncope or presyncope in the context of...

Scroll to annotate: Left Anterior Fascicular Block (LAFB) Typical ECG of LAFB, demonstrating: • rS complexes in leads II, III, aVF, with small R waves and deep S waves • qR complexes in leads I, aVL, with small Q waves and tall R waves • Left Axis Deviation (LAD): Leads II, III and aVF are NEGATIVE; Leads I and aVL are POSITIVE Associated features include: • QRS duration normal or slightly prolonged (80-110ms) • Increased QRS voltage in limb leads Electrophysiology In LAFB, impulses are conducted to the left ventricle (LV) via the posterior fascicle, which inserts into the inferoseptal wall of the LV along its endocardial surface • Depolarisation spreads from endocardium to epicardium and thus the initial vector is directed downwards and rightwards, towards inferior leads. This produces small R waves in leads II, III and aVF, and small Q waves in leads I and aVL • The major wave of depolarisation is slightly delayed and spreads upwards and leftwards, producing tall R waves in left-sided leads and deep S waves in inferior leads • This overall delay of approximately 20ms (compared with normal simultaneous conduction via both fascicles) results in a slight widening of the QRS • Because impulses reach the left-sided leads later than normal, there is an increase R wave peak time in aVL (time from onset of QRS to peak of R wave) Sequence of conduction in LAFB • YELLOW line: Impulses are conducted to the left ventricle via the posterior fascicle • RED arrow: Initial depolarisatio...

Medical condition Left anterior fascicular block Left anterior fascicular block (LAFB) is an abnormal condition of the It is caused by only the Mechanism [ ] Normal activation of the left ventricle (LV) proceeds down the left bundle branch, which consist of three fascicles, the left anterior fascicle, the left posterior fascicle, and the septal fascicle. The posterior fascicle supplies the posterior and inferoposterior walls of the LV, the anterior fascicle supplies the upper and anterior parts of the LV and the septal fascicle supplies the septal wall with innervation. LAFB — which is also known as left anterior hemiblock (LAHB) — occurs when a cardiac impulse spreads first through the left posterior fascicle, causing a delay in activation of the anterior and upper parts of the LV. Although there is a delay or block in activation of the left anterior fascicle there is still preservation of initial left to right septal activation as well as preservation of the inferior activation of the LV (preservation, on the [ citation needed] Diagnosis [ ] • Abnormal left axis deviation • qR pattern (small q, tall R) in the lateral limb leads I and aVL • rS pattern (small r, deep S) in the inferior leads II, III, and aVF • Delayed LAFB cannot be diagnosed when a prior inferior wall myocardial infarction (IMI) is evident on the ECG. IMI can also cause extreme left-axis deviation, but will manifest with Q-waves in the inferior leads II, III, and aVF. By contrast, QRS complexes in the inf...

A bifascicular block delays or stops electrical signals between the left and right bundle branches (fascicles). This problem affects your heart’s lower pumping chambers (ventricles), causing it to pump too slowly or out of rhythm (arrhythmia). Pacemakers or ICDs treat heart blocks by sending electrical signals that regulate heart rhythm. Overview What is a bifascicular block? A bifascicular block is a type of heart block. It slows the transmission of electrical signals between two of your heart’s three bundle branches. Specialized heart muscle cells called fascicles make up these bundle branches. Bundle branches in your heart’s lower chambers (ventricles) conduct electrical impulses. These signals help your heart contract and pump blood in a coordinated way. Congenital heart disease and heart (cardiovascular) disease can cause a bifascicular block. A heart block affects your heart’s pumping action. A severe bifascicular blockage that causes symptoms requires treatment. What is the definition of a bifascicular block? The prefix “bi” indicates two. With a bifascicular block, there are two types of heart blockages below your atrioventricular node (AV). Healthcare providers consider this to be an incomplete heart block. Where are the fascicles in the heart ventricles? Your Bifascicular blocks affect your ventricles. A typical heart has two ventricles: • Right ventricle: This lower-right heart chamber sends blood to the • Left ventricle: Your left ventricle (lower-left chamber)...

Fascicular block (hemiblock): left anterior fascicular block & left posterior fascicular block Fascicular blockswerepreviously referred to as hemiblocks, but the latter term has been deprecated. The left bundle branch is subdivided into the following two fascicles: (1) the anterior (anterosuperior) fascicle, whichdelivers the electrical impulse to the anterior wall of the left ventricle; (2) the posterior (posteroinferior) fascicle, whichdelivers the electrical impulse to the posterior and inferiorwalls of the left ventricle. Anatomical or functional block in the anterior fascicle leads toleft anterior fascicular block. Similarly, left posterior fascicular block is due to block in the posterior fascicle.Approximately 5–10% of all individuals have a third fascicle – the median or centroseptal fascicle –whichgives off Fascicular blocks occurdue toanatomical or functional block in a fascicle. This alters the Block in the anterior fascicle causes left anterior fascicular block (LAFB).Block in the posteriorfascicle causes leftposteriorfascicular block (LPFB). In case of a fascicular block, the wall/walls without fascicular supply will depend on impulses spreading from the other part of the ventricle (where the fascicle is intact). Figure 1. Left anterior fascicular block (hemiblock) and left posterior fascicular block (hemiblock). Inspired by GS Wagner (Marriott’s Practical Electrocardiography, Elsevier 2007) and AL Goldberg (Clinical Electrocardiography: A Simplified Approach,...

Clinically, bifascicular block presents with one of two ECG patterns: • Right bundle branch block ( • RBBB and left posterior fascicular block ( * Some authors describe Left bundle branch block ( LBBB) as a bifascicular block, as it may indicate LAFB + LPFB. However, clinically the term bifascicular block is reserved for RBBB with either LAFB or LPFB Electrophysiology Bifascicular block involves conduction delay below the atrioventricular node in two of the three fascicles: • Conduction to the ventricles is via the single remaining fascicle • The ECG will show typical features of RBBB plus either left or right axis deviation. • RBBB + LAFB is the most common of the two patterns. This is due to a single coronary artery blood supply (LAD) to the anterior fascicle • RBBB + LPFB is less common due to a dual blood supply (right and left circumflex arteries), and this combination may be associated with more extensive underlying cardiac pathology Clinical significance Bifascicular block is often associated with structural heart disease (50-80%) and extensive fibrosis of the conducting system. There is a risk of progression to complete heart block with additional damage to the third remaining fascicle, however clinical context is important: • Overall rate of progression to complete heart block is 1-4% per year • In symptom free patients, these figures are ~1% per year • Patients presenting with syncope have a 17% annual risk of progression • Syncope or presyncope in the context of...

A bifascicular block delays or stops electrical signals between the left and right bundle branches (fascicles). This problem affects your heart’s lower pumping chambers (ventricles), causing it to pump too slowly or out of rhythm (arrhythmia). Pacemakers or ICDs treat heart blocks by sending electrical signals that regulate heart rhythm. Overview What is a bifascicular block? A bifascicular block is a type of heart block. It slows the transmission of electrical signals between two of your heart’s three bundle branches. Specialized heart muscle cells called fascicles make up these bundle branches. Bundle branches in your heart’s lower chambers (ventricles) conduct electrical impulses. These signals help your heart contract and pump blood in a coordinated way. Congenital heart disease and heart (cardiovascular) disease can cause a bifascicular block. A heart block affects your heart’s pumping action. A severe bifascicular blockage that causes symptoms requires treatment. What is the definition of a bifascicular block? The prefix “bi” indicates two. With a bifascicular block, there are two types of heart blockages below your atrioventricular node (AV). Healthcare providers consider this to be an incomplete heart block. Where are the fascicles in the heart ventricles? Your Bifascicular blocks affect your ventricles. A typical heart has two ventricles: • Right ventricle: This lower-right heart chamber sends blood to the • Left ventricle: Your left ventricle (lower-left chamber)...

• Electrocardiogram (ECG or EKG). This quick and painless test measures the electrical activity of the heart. During an ECG, sensors (electrodes) are attached to the chest and sometimes to the arms or legs. An ECG can show how well the heart is beating. It can show signs of a bundle branch block, as well as which side of the heart is being affected. • Echocardiogram. This test uses sound waves to provide detailed images of the heart and heart valves. It can show the structure and the thickness of the heart muscle. Your provider can use this test to pinpoint a condition that caused the bundle branch block. Treatment Most people with bundle branch block don't have symptoms and don't need treatment. For example, left bundle branch block is not treated with medications. However, treatment depends on the specific symptoms and other heart conditions. Medications If you have a heart condition causing bundle branch block, treatment might involve medications to reduce high blood pressure or reduce symptoms of heart failure. Surgeries and other procedures If you have bundle branch block and a history of fainting, your health care provider might recommend a pacemaker. A pacemaker is a small device implanted under the skin of the upper chest. Two wires connect it to the right side of the heart. The pacemaker releases electrical impulses when needed to keep the heart beating regularly. If you have bundle branch block with low heart-pumping function, you may need cardiac resynchronizati...

Fascicular block (hemiblock): left anterior fascicular block & left posterior fascicular block Fascicular blockswerepreviously referred to as hemiblocks, but the latter term has been deprecated. The left bundle branch is subdivided into the following two fascicles: (1) the anterior (anterosuperior) fascicle, whichdelivers the electrical impulse to the anterior wall of the left ventricle; (2) the posterior (posteroinferior) fascicle, whichdelivers the electrical impulse to the posterior and inferiorwalls of the left ventricle. Anatomical or functional block in the anterior fascicle leads toleft anterior fascicular block. Similarly, left posterior fascicular block is due to block in the posterior fascicle.Approximately 5–10% of all individuals have a third fascicle – the median or centroseptal fascicle –whichgives off Fascicular blocks occurdue toanatomical or functional block in a fascicle. This alters the Block in the anterior fascicle causes left anterior fascicular block (LAFB).Block in the posteriorfascicle causes leftposteriorfascicular block (LPFB). In case of a fascicular block, the wall/walls without fascicular supply will depend on impulses spreading from the other part of the ventricle (where the fascicle is intact). Figure 1. Left anterior fascicular block (hemiblock) and left posterior fascicular block (hemiblock). Inspired by GS Wagner (Marriott’s Practical Electrocardiography, Elsevier 2007) and AL Goldberg (Clinical Electrocardiography: A Simplified Approach,...