Let’s jump in– can you decipher the EKG below to find out what’s wrong with this patient’s His-Purkinje system?
2/ If you thought left anterior fascicular block (LAFB), you were right!
What is the formal criteria for LAFB?!
✅Left axis deviation w/o LVH
✅qR pattern in lead aVL
✅R-peak time in lead aVL of 45 ms or more
✅QRS duration less than 120 ms
3/ Why do our patients get LAFB?!
Think fibrosis in the left anterior fascicle! This causes a slowed electrical conduction → EKG findings.
4/ Clinically, what do we do when we identify a patient with LAFB?
☑️Ask why! Think about causes for fibrosis, particularly hypertension or structural heart disease
☑️Stay vigilant! LAFB has corresponded to increased risk of cardiac problems like Afib or HF