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Left bundle branch block (LBBB) is a conduction abnormality in the heart that can be seen on an electrocardiogram (ECG). [1] In this condition, activation of the left ventricle of the heart is delayed, which causes the left ventricle to contract later than the right ventricle .
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.
A bundle branch block can be diagnosed when the duration of the QRS complex on the ECG exceeds 120 ms. A right bundle branch block typically causes prolongation of the last part of the QRS complex and may shift the heart's electrical axis slightly to the right.
So if the block happens on the right side, it’s referred to as a right bundle branch block. So with this type, the electrical signal starts at the SA node, contracts the atria, moves through the AV node, splits at the bundle of His, and then moves down the left bundle branch but is blocked on the right bundle branch.
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.
When a bundle branch or their fascicles becomes injured (by underlying heart disease, myocardial infarction, or cardiac surgery), it may cease to conduct electrical impulses appropriately, resulting in altered pathways for ventricular depolarization. This condition is known as a bundle branch block. [3]
A bundle branch block either LBBB or RBBB, (although RBBB is known to be associated only with S1 split), will produce continuous splitting but the degree of splitting will still vary with respiration. When the pulmonary valve closes before the aortic valve, this is known as a "paradoxically split S 2 ". [6]
In the presence of bundle branch block or ventricular hypertrophy, the depolarization impulse takes a longer than normal period of time to reach the recording electrode. This delays the onset of the intrinsicoid deflection. This prolongation or delay is an important criterion for diagnosing bundle branch block or ventricular hypertrophy.