Could this intermittent prominent anterior force be a septal fascicle block?
Daniel Teixeira de Campos E Barreiro1, Lívia Maria de Paula Castro1, José Nunes de Alencar2
1Faculdade de Medicina de Marília, Rua Monte Carmelo, 800, Marília 17519-030, Brazil.
Background:
A septal fascicle of the left bundle branch is an anatomical variant present in a substantial number of human hearts. However, the electrocardiographic features of its block remain controversial.
Case Summary:
We describe a case of transitory prominent anterior forces consistent with an intermittent left septal fascicle block, identified on a preoperative ECG of an adult male with a history of diabetes mellitus and systemic hypertension.
Conclusion:
Clinicians should recognize septal fascicular block as an emerging and underrecognized cause of a prominent R-wave in the right precordial leads, particularly when the pattern is intermittent.
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