A left anterior fascicular block, also known as left anterior hemiblock, occurs when the anterior fascicle of the left bundle branch is no longer able to conduct action potentials. Show
The criteria to diagnose a LAFB, or LAHB, on ECG include the following:
A very quick way to diagnose a left anterior fascicular block on ECG is to first identify the left axis deviation; see image below. If the QRS complex is up in lead I and down in lead aVF while also down in lead II, then left axis deviation is present. Then look at lead III. If there is an rS complex, then you have a LAFB on ECG. This method should take just a few seconds. Note: An old inferior wall myocardial infarction is not able to be diagnosed in the setting of a left anterior fascicular block due to the inferior Q waves present from the LAFB. A left anterior fascicular block can also occur in the setting of a bifascicular or trifascicular block. Below is a bifascicular block with a LAFB on ECG. Note there is also a right bundle branch block. ECG Examples:
References: Brazilian Society of Cardiology Guidelines on the Analysis and Issuance of Electrocardiographic Reports - 2022. Samesima N, God EG, Kruse JCL, Leal MG, Pinho C, França FFAC, Pimenta J, Cardoso AF, Paixão A, Fonseca A, Pérez-Riera AR, Ribeiro ALP, Madaloso BA, Luna Filho B, Oliveira CAR, Grupi CJ, Moreira DAR, Kaiser E, Paixão GMM, Feitosa Filho G, Pereira Filho HG, Grindler J, Aziz JL, Molina MS, Facin M, Tobias NMMO, Oliveira PA, Sanches PCR, Teixeira RA, Atanes SM, Pastore CA. Samesima N, et al. Arq Bras Cardiol. 2022 Oct;119(4):638-680. doi: 10.36660/abc.20220623. Arq Bras Cardiol. 2022. PMID: 36287420 Free PMC article. English, Portuguese. No abstract available. With a left anterior fascicular block, the left ventricle in your heart contracts later than normal because your heart’s electrical signal can’t get through when it should. Although people with this issue don’t usually have symptoms or need treatment, they are likely to have other heart issues in the future.
OverviewLeft anterior fascicular block stopping a signal.What is left anterior fascicular block?A left anterior fascicular block is the term for something interfering with your heartbeat’s signal when it gets to the left anterior fascicle of your heart’s left bundle branch. This makes your heart’s left ventricle contract later than your heart’s right ventricle. How common is left anterior fascicular block?An estimated 1% to 6% of the population has left anterior fascicular block. Most are senior adults. Symptoms and CausesWhat are the symptoms of left anterior fascicular block?Left anterior fascicular block usually has no symptoms. If your case is severe, you may experience:
What causes left anterior fascicular block?Researchers think some people may have an inherited tendency to have abnormal electrical signals in their heart’s lower chambers. More established causes include:
Management and TreatmentHow is left anterior fascicular block treated?There’s no specific treatment for left anterior fascicular block, but you’ll most likely need treatment for what caused the block — heart disease. Outlook / PrognosisWhat is the outlook for left anterior fascicular block?The outlook is good for young people with left anterior fascicular block, but they rarely have it. A left anterior fascicular block diagnosis may be benign, but researchers found that people with left anterior fascicular block have a higher risk of congestive heart failure, atrial fibrillation and death. Some studies say left bundle branch block can be a predictor of heart failure, heart attack and sudden cardiac death, especially for people older than 50. Living WithHow do I take care of myself?Since left anterior fascicular block can be an indicator or predictor of multiple heart problems, it’s best to take care of your heart to prevent these issues. You can:
When should I see my healthcare provider?Go to your regular checkups to make sure your healthcare provider can monitor any chronic issues, such as high blood pressure and high cholesterol. Contact your provider if you notice changes in how you feel, especially if you’re out of breath when you walk. When should I go to the ER?Call 911 if you have these signs of a heart attack:
What questions should I ask my doctor?
A note from Cleveland Clinic Although left anterior fascicular block doesn’t need treatment, you should be aware that researchers have seen connections between it and other heart issues. Take care of your heart to protect it from coronary artery disease and heart failure. Keep your checkup appointments with your healthcare provider and be sure to take the medicines your provider prescribed for you. Get useful, helpful and relevant health + wellness information
enews More health news + info Is Fascicular block the same as bundle branch block?Bundle branch block is partial or complete interruption of impulse conduction in a bundle branch; fascicular block is similar interruption in a hemifascicle of the bundle. The 2 disorders often coexist. There are usually no symptoms, but presence of either suggests a heart disorder. Diagnosis is by electrocardiography.
Is left anterior fascicular block serious?Individuals with left anterior fascicular block more often developed atrial fibrillation (p<0.001), congestive heart failure (p<0.001), and death (p<0.001), when compared to those without conduction disease.
What is right bundle branch block with LAFB?RBBB + LAFB is the most common of the two patterns. This is due to a single coronary artery blood supply (LAD) to the anterior fascicle. RBBB + LPFB is less common due to a dual blood supply (right and left circumflex arteries), and this combination may be associated with more extensive underlying cardiac pathology.
Is right bundle branch block serious?How serious is a right bundle branch block? If you have no symptoms and no heart disease, a right bundle branch block is not serious. But if you've already had heart failure or a heart attack along with right bundle branch block, it puts you at a higher risk of death.
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Right bundle branch block and left anterior fascicular block
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