Podcast
Questions and Answers
What is Tri-Fascicular Block and what is the resulting heart block?
What is Tri-Fascicular Block and what is the resulting heart block?
Tri-Fascicular Block involves all three fascicles below the AV node, resulting in complete heart block.
What are the two possible additional characteristics of Tri-Fascicular Block?
What are the two possible additional characteristics of Tri-Fascicular Block?
Either LAFB or LPFB.
What are some causes of Tri-Fascicular Block?
What are some causes of Tri-Fascicular Block?
Causes include ischemic heart disease, structural heart disease, aortic stenosis, anterior myocardial infarction, congenital heart disease, hyperkalemia, and digoxin toxicity.
How does Tri-Fascicular Block differ from Bi-Fascicular Block?
How does Tri-Fascicular Block differ from Bi-Fascicular Block?
What is the significance of the AV node in Tri-Fascicular Block?
What is the significance of the AV node in Tri-Fascicular Block?
What is the axis deviation indicated by a negative lead II?
What is the axis deviation indicated by a negative lead II?
What is a possible cause of left axis deviation?
What is a possible cause of left axis deviation?
What is the significance of the R-wave in an ECG?
What is the significance of the R-wave in an ECG?
What is R-wave progression?
What is R-wave progression?
In normal R-wave progression, what is the pattern of the R-wave in leads V1-V2?
In normal R-wave progression, what is the pattern of the R-wave in leads V1-V2?
What is the pattern of the R-wave in leads V3-V4 in normal R-wave progression?
What is the pattern of the R-wave in leads V3-V4 in normal R-wave progression?
What is the pattern of the R-wave in leads V5-V6 in normal R-wave progression?
What is the pattern of the R-wave in leads V5-V6 in normal R-wave progression?
What are some causes of extreme axis deviation?
What are some causes of extreme axis deviation?
What is the common cause of Left Anterior Fascicular Block (LAFB) and Left Posterior Fascicular Block (LPFB)?
What is the common cause of Left Anterior Fascicular Block (LAFB) and Left Posterior Fascicular Block (LPFB)?
What is Bi-Fascicular Block?
What is Bi-Fascicular Block?
What is a common cause of Left Posterior Fascicular Block (LPFB)?
What is a common cause of Left Posterior Fascicular Block (LPFB)?
What is a common cause of poor R-Wave progression in an ECG?
What is a common cause of poor R-Wave progression in an ECG?
What is the term for an incomplete RBBB when the rSR' pattern is present in V1 but the QRS is normal?
What is the term for an incomplete RBBB when the rSR' pattern is present in V1 but the QRS is normal?
What is the term for a blockage of the left anterior descending coronary artery, which can cause an LBBB?
What is the term for a blockage of the left anterior descending coronary artery, which can cause an LBBB?
Causes of Poor R-Wave Progression
Causes of Poor R-Wave Progression
Left Anterior Fascicular Block (LAFB) Characterized
Left Anterior Fascicular Block (LAFB) Characterized
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Study Notes
Causes of Fascicular Blocks
- Causes of Left Anterior Fascicular Block (LAFB) include myocardial infarction, coronary artery disease, left ventricular hypertrophy, dilated cardiomyopathy, hypertrophic cardiomyopathy, degenerative disease, hypertension, hyperkalemia, myocarditis, and amyloidosis.
- Causes of Left Posterior Fascicular Block (LPFB) include ischemic heart disease, hyperkalemia, myocarditis, and cor pulmonale.
Characterization of Fascicular Blocks
- LAFB is characterized by RAD, a negative rS complex in lateral leads, a positive qS complex in inferior leads, and increased QRS voltage in limb leads.
- LPFB is characterized by RAD, a negative rS complex in inferior leads, a positive qS complex in lateral leads, and increased QRS voltage in limb leads.
Bi-Fascicular and Tri-Fascicular Blocks
- Bi-Fascicular Block involves two of the three fascicles, either RBBB + LAFB or RBBB + LPFB.
- Tri-Fascicular Block involves all three fascicles below the AV node, resulting in complete heart block plus RBBB and either LAFB or LPFB.
- Causes of Bi-Fascicular and Tri-Fascicular Blocks include ischemic heart disease, structural heart disease, aortic stenosis, anterior myocardial infarction, congenital heart disease, hyperkalemia, and digoxin toxicity.
Causes of Left Axis Deviation
- Causes of Left Axis Deviation include left ventricular hypertrophy, inferior myocardial infarction, Wolff-Parkinson-White (WPW) syndrome, ventricular pacing, ventricular rhythms, and hyperkalemia.
R-Wave Progression
- R-Wave Progression is the electrical depolarization of the ventricles being seen from lead V1 to V6.
- In normal R-wave progression, the R-wave is negative in V1-V2, becomes biphasic in V3-V4, and then positive in V5-V6.
Causes of Poor R-Wave Progression
- Causes of Poor R-Wave Progression include myocardial infarction, cardiomyopathy, right and left ventricular hypertrophy, bundle branch blocks, and axis deviation.
Bundle Branch Blocks
- Right Bundle Branch Block (RBBB) is characterized by a wide QRS due to a delay in conduction, with a predominantly positive QRS in V1 and a W pattern in V6.
- Causes of RBBB include right ventricular hypertrophy, pulmonary embolism, ischemic heart disease, rheumatic heart disease, congenital heart defects, myocarditis, and cardiomyopathy.
- Incomplete RBBB is characterized by the presence of an rSR' pattern in V1 but a normal QRS.
- Left Bundle Branch Block (LBBB) is characterized by a wide QRS due to a delay in conduction, with a predominantly negative QRS in V1 and a positive M shape in V6.
- Causes of LBBB include dilated cardiomyopathy, aortic stenosis, ischemic heart disease, hypertension, anterior myocardial infarction, hyperkalemia, and digoxin toxicity.
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