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Dr A Röschl's picture

Atrial Flutter With Right Bundle Branch Block and Left Anterior Fascicular Block In a Patient With Preexisting RBBB + LAFB

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. 80%, in patients with a previous myocardial infarction (...) approx. 90%). Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. In this constellation, 3 causes must be considered:
1. fascicular tachycardia from the left posterior fascicle of the left tawara fascicle (QRS width usually only around 130 ms, but sometimes significantly longer).
2. AT/AFL with 2:1 conduction in the case of pre-existing bifascicular block

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