0071643192.pdf

ECG FINDINGS

■ LBBBor

■ RBBB+LAFBorLPFB

TREATMENT

■ Transvenous pacing if

■ Symptomatic bradycardia

■ Acute MI (extensive damage to conducting system)

TRIFASCICULARBLOCK

Trifascicular block occurs when any combination of three fascicular blocks

are found concomitantly.

ECG FINDINGS

■ Bifascicular block + first-degree AV block or

■ Alternating RBBB and LBBB

TREATMENT

■ Transvenous pacing if

■ Symptomatic bradycardia

■ In the setting of an acute myocardial infarction (AMI))(extensive

damage to conducting system)

Ventricular Hypertrophy

RIGHTVENTRICULARHYPERTROPHY(RVH)

Prominent right-sided forces cause the pattern of RVH on surface ECG.

CARDIOVASCULAR EMERGENCIES

FIGURE 2.4. Left posterior fascicular block.

(Reproduced, with permission, from Tintinalli JE, Kelen GD, Stapczynski JS. Emergency Medicine:

A Comprehensive Study Guide, 6th ed. New York: McGraw-Hill, 2004:195.)

Bifascicular blocks:

■LBBB

■RBBB + LAFB

■RBBB + LPFB

Trifascicular blocks:

■Bifascicular block + first-

degree AV block

■AlternatingRBBB & LBBB

Trifascicular block in the

setting of MI necessitates

permanent pacemaker

insertion.