Left posterior fascicular block
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| Left posterior fascicular block Classification and external resources | |
| ICD-10 | I44.-I45. |
|---|---|
| ICD-9 | 426.9 |
| DiseasesDB | 10477 |
| MeSH | D006327 |
| Cardiology Network |
 Discuss Left posterior fascicular block further in the WikiDoc Cardiology Network |
| Adult Congenital |
|---|
| Biomarkers |
| Cardiac Rehabilitation |
| Congestive Heart Failure |
| CT Angiography |
| Echocardiography |
| Electrophysiology |
| Cardiology General |
| Genetics |
| Health Economics |
| Hypertension |
| Interventional Cardiology |
| MRI |
| Nuclear Cardiology |
| Peripheral Arterial Disease |
| Prevention |
| Public Policy |
| Pulmonary Embolism |
| Stable Angina |
| Valvular Heart Disease |
| Vascular Medicine |
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Overview
Left posterior fascicular block (also known as LPFB or Left Posterior Hemiblock or LPH) is characterized by a mean frontal plane axis of >90° in the absence of other causes of right axis deviation. Left posterior hemiblock (left posterior fascicular block) is infrequent.[1] Its seen either in the setting of either RCA or LAD related pathologies.
Anatomical Course of the Left Fascicle
The left posterior fascicle is a distal extension of the left main bundle and courses posteriorly toward the posterior papillary muscle which is located in the posterior, medial and inferior aspect of left ventricle and inferoposteriorly toward the left ventricular free wall. [2]
Blood Supply of the Left Posterior Fascicle
The proximal part of the left posterior fascicle is supplied by the artery supplying the atrioventricular (AV) node (often the right coronary artery) and, at times, by septal branches of the left anterior descending (LAD) artery.
Diagnosis
The diagnosis is often made in the context of previous ECGs. The frontal QRS axis is rightward and there are no other potential causes of right axis deviation such as right ventricular hypertrophy and prior lateral myocardial infarction.
- QRS axis of 100 to 180 degrees
- QRS duration 80-100 msec (usually normal or slightly widened qRS complex)
- Deep S in lead I and aVL (rS in I and aVL)
- qR in II, III, and aVF
Examples
References
See Also
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
