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Left anterior fascicular block (LAFB) is an abnormal condition of the left ventricle of the heart, [1] [2] related to, but distinguished from, left bundle branch block (LBBB). It is caused by only the left anterior fascicle – one half of the left bundle branch being defective. It is manifested on the ECG by left axis deviation.
Normal variation causing LAD is an age-related physiologic change. Conduction defects such as left bundle branch block or left anterior fascicular block can cause LAD on the ECG. Pre-excitation syndrome as well as congenital heart diseases such as atrial septal defect, endocardial cushion defects can also cause LAD on ECG.
Left bundle branch block. Left anterior fascicular block; Left posterior fascicular block; Right bundle branch block; This is in contrast to a permanent dysfunction of the electrical pathways that produces wide QRS complexes in one of the above patterns or combinations of patterns (ie, bifascicular block).
Left posterior fascicular block. Only the posterior part of the left bundle branch is involved; Other classifications of bundle branch blocks are; Bifascicular block. This is a combination of right bundle branch block (RBBB) and either left anterior fascicular block (LAFB) or left posterior fascicular block (LPFB) Trifascicular block.
The axis may be normal but may be deviated to the left or right. [4] There are also partial blocks of the left bundle branch: "left anterior fascicular block" (LAFB) [5] and a "left posterior fascicular block" (LPFB). [5] This refers to the block after the bifurcation of the left bundle branch.
An intraventricular block is a heart conduction disorder — heart block of the ventricles of the heart. [1] An example is a right bundle branch block, right fascicular block, bifascicular block, trifascicular block. [2] [3]
Infra-Hisian block is that of the distal conduction system. Types of infra-Hisian block include: Type 2 second degree heart block (Mobitz II) – a type of AV block due to a block within or below the bundle of His [5] Left anterior fascicular block; Left posterior fascicular block; Right bundle branch block; Left bundle branch block
It is usually an incidental finding on a routine ECG. [4] First-degree heart block does not require any particular investigations except for electrolyte and drug screens, especially if an overdose is suspected. [5] In comparison to second-degree atrioventricular block, in first-degree block there is an absence of non-conduction or "dropped beats."
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