• Source: Bifascicular block

Bifascicular block is characterized by right bundle branch block with left anterior fascicular block, or right bundle branch block with left posterior fascicular block on electrocardiography. Complete heart block could be the cause of syncope that is otherwise unexplained if bifascicular block is seen on electrocardiography. It is estimated that less than 50% of patients with bifascicular block have high-degree atrioventricular block, although the exact incidence is unknown.
The European Society of Cardiology (ESC) suggests using electrophysiology studies to look into it (EPS). When pharmacologic stress or incremental atrial pacing induces high-degree atrioventricular block, a permanent pacemaker (PPM) is recommended. If EPS is negative, long-term rhythm monitoring with an implantable loop recorder (ILR) is advised.
Most commonly, it refers to a combination of right bundle branch block (RBBB) and either left anterior fascicular block (LAFB) or left posterior fascicular block (LPFB), with the former being more common.




Signs and symptoms


Patients who suffer from bifascicular block are more likely to experience syncope and unexpected death.




Diagnosis






Treatment


In those with bifascicular block and no symptoms, little with respect to treatment is needed. In those with syncope, a pacemaker is recommended.




See also


Trifascicular block
Bundle branch block




References






Further reading


Steinberg, Jonathan S.; Pokushalov, Evgeny; Zeidan-Shwiri, Tawfiq; Crystal, Eugene; Nakamura, Kohki; Naito, Shigeto; Ávila, Pablo; Arenal, Ángel; Shah, Shivang; Jain, Sandeep; Donnellan, Eoin; Tchou, Patrick (August 1, 1973). "Bifascicular block: A clinical and electrophysiologic study". American Heart Journal. 86 (2). Mosby: 173–181. doi:10.1016/0002-8703(73)90241-X. ISSN 0002-8703. PMID 4719938. Retrieved December 30, 2023.
Kiehl, Erich L.; Cantillon, Daniel J.; Heidecker, Bettina; Jr, Leslie T. Cooper; Singh, Gagan D.; Rogers, Jason H.; Wilson, Ryan E.; Ziada, Khaled M.; John, Roy M.; Jr, Thomas K. Varghese (January 1, 2017). "Bradyarrhythmias—Conduction System Abnormalities". Arrhythmia Essentials. Elsevier. pp. 28–86. doi:10.1016/B978-0-323-39968-5.00002-0. ISBN 9780323399685. Retrieved December 30, 2023.




External links


Cleveland Clinic
Life in the Fast Lane

Kata Kunci Pencarian:

• Bifascicular block
• Trifascicular block
• Third-degree atrioventricular block
• Bundle branch block
• Intraventricular block
• Right axis deviation
• Cardiac aberrancy
• Sinus rhythm
• Fascicular block
• Transcutaneous pacing