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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.
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.
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.
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
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A subset of individuals with the triad of first-degree heart block, right bundle branch block, and either left anterior fascicular block or left posterior fascicular block (known as trifascicular block) may be at an increased risk of progression to complete heart block. [8]
Bifascicular block is characterized by right bundle branch block with left anterior fascicular block, or right bundle branch block with left posterior fascicular block on electrocardiography. Complete heart block could be the cause of syncope that is otherwise unexplained if bifascicular block is seen on electrocardiography. [1]