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In search of left septal fascicular block
1Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, Calif, USA. rmacalpi@ucla.edu
American Heart Journal
|December 18, 2002
Summary
The existence of left septal fascicle block, a controversial electrocardiographic finding, is supported by new diagnostic criteria. This condition, found in 0.5% of ECGs, may explain unclear electrocardiogram abnormalities.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Diagnostics
Background:
- The left bundle branch in humans typically trifurcates into anterior, posterior, and septal fascicles.
- Conduction abnormalities in the anterior and posterior fascicles are well-established.
- Diagnosis of left septal fascicle block remains controversial due to a lack of consensus criteria.
Purpose of the Study:
- To investigate the existence of left septal fascicle block.
- To establish diagnostic criteria for left septal fascicle block.
- To explore the clinical significance of this condition.
Main Methods:
- A retrospective review of approximately 26,000 electrocardiograms (ECGs).
- Application of newly derived criteria for left septal fascicle block.
- Selection and analysis of illustrative ECG examples.
Main Results:
- Electrocardiograms consistent with left septal fascicle block were identified in approximately 0.5% of the reviewed tracings.
- The study presents illustrative ECG examples supporting the proposed diagnostic criteria.
- Reasons for the selection of these specific ECGs are discussed.
Conclusions:
- The findings suggest that left septal fascicle block is a real electrocardiographic entity.
- Left septal fascicle block exhibits polymorphic patterns.
- This condition may account for previously unexplained electrocardiographic abnormalities.