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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.
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.
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]
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
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.
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.
A right bundle branch block (RBBB) is a heart block in the right bundle branch of the electrical conduction system. [1] During a right bundle branch block, the right ventricle is not directly activated by impulses traveling through the right bundle branch. However, the left bundle branch still normally activates the left ventricle.
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).