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Left Posterior Fascicular Block Left Posterior Fascicular Block (Example) A left posterior fascicular block (LPFB) also known as a left posterior hemiblock (LPHB) occurs when the posterior fascicle of the left bundle branch is no longer able to conduct action potentials. This is much less common than a left anterior fascicular block since the posterior fascicle is much more sparsely distributed, so a large amount of myocardial tissue must be damaged to block the posterior fascicle. The criteria to diagnose a LPFB is as follows: 1) Right axis deviation of 90 to 180 degrees 2) The presence of a qR complex in lead III and a rS complex in lead I. 3) Absence of RAE and RVH. Note: The above pattern sometimes appears similar to the S1Q3T3 pattern sometimes present in a patient with a pulmonary embolus |
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