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Bifascicular block is characterized by right bundle branch block with left anterior fascicular block, or right bundle branch block with left posterior fascicular block on electrocardiography. Complete heart block could be the cause of syncope that is otherwise unexplained if bifascicular block is seen on electrocardiography . [ 1 ]
Bifascicular block is a combination of right bundle branch block and either left anterior fascicular block or left posterior fascicular block. Conduction to the ventricle would therefore be via the remaining fascicle. The ECG will show typical features of RBBB plus either left or right axis deviation. [7] [8]
An intraventricular block is a heart conduction disorder — heart block of the ventricles of the heart. [1] An example is a right bundle branch block, right fascicular block, bifascicular block, trifascicular block. [2] [3]
Diagnosis is based on an ECG showing ST-segment depression at the J-point of 1 to 3 mm in leads V1 to V6, with tall and symmetrical T waves. [1] The ST-segment is upsloping and there is also often ST-segment elevation of 0.5 to 2 mm in lead aVR. [1] [2] The QRS complex is either normal or slightly wide. [1]
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The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the left. The ECG will show a QS or rS complex in lead V1 and a monophasic R wave in lead I.
Left bundle branch block. Left anterior fascicular block; Left posterior fascicular block; Right bundle branch block; This is in contrast to a permanent dysfunction of the electrical pathways that produces wide QRS complexes in one of the above patterns or combinations of patterns (ie, bifascicular block).
ECG recorded from a 17-year-old male with Lown-Ganong-Levine syndrome. LGL syndrome is diagnosed in a person who has experienced episodes of abnormal heart racing (arrhythmias) who has a PR interval less than or equal to 0.12 second (120 ms) with normal QRS complex configuration and duration on their resting ECG. [1]. [citation needed]