Left Posterior Fascicular Block (Left Anterior Hemiblock)

Definition

  • Intraventricular Conduction Delay (IVCD): abnormality in intraventricular signal conduction which results in a change in the shape or duration of the QRS complex

Classification of Intraventricular Conduction Delays (IVCD)

  • General Comments: refers to abnormalities in intraventricular signal conduction which result in a change in the shape or duration of the QRS complex
  • Left Bundle Branch Block (LBBB) (see Left Bundle Branch Block, [[Left Bundle Branch Block]])
  • Right Bundle Branch Block (RBBB) (see Right Bundle Branch Block, [[Right Bundle Branch Block]])
  • Left Anterior Fascicular Block (Left Anterior Hemiblock) (see Left Posterior Fascicular Block, [[Left Anterior Fascicular Block]])
  • Left Posterior Fascicular Block (Left Posterior Hemiblock)

Epidemiology

  • xxx

Etiology

  • xxx

Physiology

Blood Supply to Cardiac Conduction System

  • Blood Supply to the Sinoatrial (SA) Node
    • Right Coronary Artery: 60% of patients
    • Left Circumflex Artery: 40% of patients
  • Blood Supply to the Atrioventricular (AV) Node
    • Right Coronary Artery: 90% of patients
    • Left Circumflex Artery: 10% of patients
  • Blood Supply to the His Bundle
    • Right Coronary Artery: main blood supply
    • Septal Perforators of the Left Anterior Descending Coronary Artery: minor contribution
  • Main/Proximal Left Bundle Branch
    • Left Anterior Descending Artery: main blood supply
    • Right Coronary Artery: collateral flow
    • Left Circumflex Artery: collateral flow
  • Left Anterior Fascicle
    • Septal Perforators of the Left Anterior Descending Coronary Artery: main blood supply
    • AV Nodal Artery: 50% of patients
    • Left Posterior Fascicle
    • Proximal Left Posterior Fascicle
      • AV Nodal Artery: main blood supply
      • Septal Perforators of the Left Anterior Descending Coronary Artery: in some cases
    • Distal Left Posterior Fascicle
      • Anterior and Posterior Septal Perforating Arteries (Dual Blood Supply)
  • Right Bundle Branch
    • Septal Perforators of the Left Anterior Descending Artery: main blood supply
    • Right Coronary Artery: some collateral flow (depending on dominance of the system)
    • Left Circumflex Artery: some collateral flow (depending on dominance of the system)

Diagnosis

  • xxx

Clinical Manifestations

Cardiovascular Manifestations

  • xxxx

Other Manifestations

  • xxx

Treatment

  • xxx

References

  • xxx