Department of Emergency Medicine

UMEM Educational Pearls

Title: Bi & Tri-fascicular Blocks

Category: Cardiology

Posted: 6/23/2013 by Semhar Tewelde, MD
Click here to contact Semhar Tewelde, MD

Bifascicular block

  1. Right bundle branch block (RBBB) + left anterior fascicular block (LAFB) 
  2. RBBB + left posterior fascicular block (LPFB)
  3. Complete left bundle branch block (LBBB)

Incomplete Trifascicular block

  1. Bifascicular block w/1st degree AV block    *classically referred to as “trifascicular block”*
  2. Bifascicular block w/2nd degree AV block
  3. Alternating LBBB + RBBB

Complete Trifascicular block

  1. Bifascicular block w/3rd degree AV block 

References

  1. Surawicz B, Knilans T. Chou’s Electrocardiography in Clinical Practice (6th edition), Saunders 2008. 
  2. Wagner, GS. Marriott’s Practical Electrocardiography (11th edition), Lippincott Williams & Wilkins 2007.
  3. Levis J, Garmel G. Clinical Emergency Medicine Casebook, Cambridge University Press 2009. 

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