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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 use of additional ECG leads like right-sided leads V3R and V4R and posterior leads V7, V8, and V9 may improve sensitivity for right ventricular and posterior myocardial infarction. In spite of these limitations, the 12 lead ECG stands at the center of risk stratification for the patient with suspected acute myocardial infarction.
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.
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG [a]), a recording of the heart's electrical activity through repeated cardiac cycles. [4] It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart [5] using electrodes placed on the skin.
The V 5 ECG lead is placed on the anterior axillary line, horizontally even with V 4. The midaxillary line is a coronal line on the torso between the anterior and posterior axillary lines. It is a landmark used in thoracentesis, [2] and the V6 electrode of the 10 electrode ECG.
The standard 12 lead ECG does not directly examine the right ventricle, and is relatively poor at examining the posterior basal and lateral walls of the left ventricle. In particular, acute myocardial infarction in the distribution of the circumflex artery is likely to produce a nondiagnostic ECG. [10]
As the left posterior fascicle is shorter and broader than the right, impulses reach the papillary muscles just prior to depolarization, and therefore contraction, of the left ventricle myocardium. This allows pre-tensioning of the chordae tendinae, increasing the resistance to flow through the mitral valve during left ventricular contraction ...
Under these criteria, an ECG is positive for an AMI in the presence of LBBB if any of the following criteria are present: ST deviation ≥1 mm (0.1 mV) concordant with QRS polarity in any ECG lead, thus including either: ST depression ≥1 mm (0.1 mV) concordant with QRS polarity, in any ECG lead.
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