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Bifascicular heart block

See brief interpretation of 12 lead EKG above

Bifascicular heart block is the combination of right bundle branch block and block of either the left anterior fascicle or the left posterior fascicle (recall the electrical conduction system of the heart).

The fascicle involved will often be the left anterior fascicle as the left posterior fascicle receives dual blood supply and is more resistant to myocardial ischemia.

bifascicular block conduction 300x278 Bifascicular heart block

Asymptomatic bifascicular block requires no treatment. Pacemaker implantation may be relevant if the patient has seizures – however other arrhythmia such as (intermittent) AV blocks or ventricular tachycardia should also be considered as cause of seizures.

— Mathias

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