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Left posterior fascicular block

Left posterior fascicular block
Classification and external resources
ICD-10 I44.5
NCI Left posterior fascicular block
Patient UK Left posterior fascicular block

A left posterior fascicular block (LPFB) is a condition where the left posterior fascicle, which travels to the inferior and posterior portion of the left ventricle,[1] does not conduct the electrical impulses from the atrioventricular node. The wave-front instead moves more quickly through the left anterior fascicle and right bundle branch, leading to a right axis deviation seen on the ECG.[2]

The American Heart Association has defined a LPFB as:[3]

  • Frontal plane axis between 90° and 180° in adults
  • rS pattern in leads I and aVL
  • qR pattern in leads III and aVF
  • QRS duration less than 120 ms

The broad nature of the posterior bundle as well as its dual blood supply[4] makes isolated LPFB rare.[5]

See also


  1. Kevin J. Koop et al., eds. (2010). "23". Atlas of emergency medicine (3rd ed. ed.). New York: McGraw-Hill Professional. ISBN 0071496181. 
  2. "Lesson VI - ECG Conduction Abnormalities". Retrieved 2009-01-07. 
  3. Surawicz, B; Childers, R; Deal, BJ; Gettes, LS; Bailey, JJ; Gorgels, A; Hancock, EW; Josephson, M; Kligfield, P; Kors, JA; Macfarlane, P; Mason, JW; Mirvis, DM; Okin, P; Pahlm, O; Rautaharju, PM; van Herpen, G; Wagner, GS; Wellens, H; American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical, Cardiology; American College of Cardiology, Foundation; Heart Rhythm, Society (Mar 17, 2009). "AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology.". Journal of the American College of Cardiology 53 (11): 976–81. PMID 19281930. doi:10.1016/j.jacc.2008.12.013. 
  4. James, TN (Dec 1965). "Anatomy of the coronary arteries in health and disease.". Circulation 32 (6): 1029. PMID 5846099. doi:10.1161/01.cir.32.6.1020. 
  5. Rokey, R.; Chahine, R. A. (June 1984). "Isolated left posterior fascicular block associated with acquired ventricular septal Defect". Clinical Cardiology 7 (6): 364–369. doi:10.1002/clc.4960070608. 

Further reading

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