Medicine:Left posterior fascicular block

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Left posterior fascicular block
Other namesLeft posterior hemiblock

A left posterior fascicular block (LPFB), also known as left posterior hemiblock (LPH), is a condition where the left posterior fascicle, which travels to the inferior and posterior portion of the left ventricle,[1] does not conduct the electrical impulses from the atrioventricular node. The wave-front instead moves more quickly through the left anterior fascicle and right bundle branch, leading to a right axis deviation seen on the ECG.[2]

Definition

The American Heart Association has defined a LPFB as:[3]

  • Frontal plane axis between 90° and 180° in adults
  • rS pattern in leads I and aVL
  • qR pattern in leads III and aVF
  • QRS duration less than 120 ms

The broad nature of the posterior bundle as well as its dual blood supply[4] makes isolated LPFB rare.[5]

See also

References

  1. Kevin J. Koop, ed (2010). "23". Atlas of emergency medicine (3rd ed.). New York: McGraw-Hill Professional. ISBN 978-0071496186. 
  2. "Lesson VI - ECG Conduction Abnormalities". http://library.med.utah.edu/kw/ecg/ecg_outline/Lesson6/index.html#LPFB. 
  3. "AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology". J. Am. Coll. Cardiol. 53 (11): 976–81. 2009. doi:10.1016/j.jacc.2008.12.013. PMID 19281930. 
  4. James, TN (Dec 1965). "Anatomy of the coronary arteries in health and disease.". Circulation 32 (6): 1020–33. doi:10.1161/01.cir.32.6.1020. PMID 5846099. 
  5. Rokey, R.; Chahine, R. A. (June 1984). "Isolated left posterior fascicular block associated with acquired ventricular septal Defect". Clinical Cardiology 7 (6): 364–369. doi:10.1002/clc.4960070608. PMID 6744692. 

Further reading

External links

Classification