Left axis deviation and rbbb – bifascicular block [150 ECG] - Bài viết - Bệnh Học
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Left axis deviation and rbbb – bifascicular block [150 ECG]

Cho điểm
Left axis deviation and RBBB – bifascicular block
This ECG was recorded from a fit 60-year-old man at a routine medical examination. What does it show and what would you recommend?



ANSWER 97

The ECG shows:
• Sinus rhythm, rate 65/min
• Normal PR interval
• Left axis deviation – left anterior hemiblock
• QRS complex duration just over 120 ms, with an RSR1 complex in lead V1 – right bundle branch block (RBBB)
Clinical interpretation
The combination of left anterior hemiblock and RBBB is called bifascicular block. Atrioventricular conduction occurs via the posterior fascicle of the left bundle branch.

What to do
Progression to complete block can occur but is relatively rare. In the absence of symptoms, standard UK practice would be not to insert a permanent pacemaker; however, any symptoms suggestive of a bradycardia should be investigated immediately.

Summary
Left axis deviation and RBBB – bifascicular block.
Nguồn: 150 ECG Problems (4th Edition)
Tác giả: John R. Hampton

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