ECG Guru - Instructor Resources

A gathering place for instructors of ECG and cardiac topics.


Subscribe to me on YouTube

Bifascicular block

Right Bundle Branch Block With Left Posterior Fascicular Block

Mon, 05/13/2013 - 08:09 -- Dawn

This is a good clear example of right bundle branch block with left posterior fascicular block.  The RBBB is diagnosed by the following criteria:  wide QRS (.12 sec), supraventricular rhythm (NSR), an rsR' pattern in V1, and wide little s waves in I and V6.  The LPFB is inferred by the right axis deviation (Lead III QRS is a bit taller than Lead II and Leads I and aVL are negative), and the fact that there is no other obvious cause for right axis shift noted in this patient.  This constitutes a BIFASCICULAR BLOCK.

Anterior Wall M.I. With Bifascicular Block

Fri, 10/19/2012 - 20:46 -- Dawn

This is a good example of acute anterior wall M.I., with ST elevation in V1 through V6, as well as in Leads I and aVL.  The extensive distribution of ST segment elevations across the anterior and high lateral walls indicates a proximal LAD artery occlusion.  In addition, this ECG shows right bundle branch block, with a QRS width of 144 ms (.14 sec.) and an rsR' pattern in V1.

jer5150's picture

Jason's Blog: ECG Challenge of the Week for June 10-17. Why did the ventricular rate abruptly decrease?


From June 10, 2012:   As is the case with all practical blogs, I’m encouraging ECG Guru members to engage in active group participation.  Share your thoughts, observations, impressions, findings, and interpretations.  Feel free to compare notes with one another and pick each other’s brains.

Atrial Fib, Bifascicular Block, Pacemaker

Tue, 04/10/2012 - 12:53 -- Dawn

Lots of information in this ECG! The underlying rhythm is atrial fibrillation with a controlled rate. The QRS is .12 seconds in duration, with an rSR' pattern in V1 and a wide s wave in Leads I and V6, indicating right bundle branch block. In addition, the axis is leftward - Leads I and aVL are upright and Leads II, III, and aVF are negative. There is no other obvious reason for the left axis shift, and therefore, the diagnosis by exclusion is left anterior fascicular block.

All our content is FREE & COPYRIGHT FREE for non-commercial use

Please be courteous and leave any watermark or author attribution on content you reproduce.

Subscribe to RSS - Bifascicular block