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Bifascicular Block
Bifascicular block is a conduction abnormality in the heart where two of the three main fascicles of the His/Purkinje system are blocked. 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. Some authors consider left bundle branch block (LBBB) to be a technical bifascicular block, since the block occurs above the bifurcation of the left anterior and left posterior fascicles of the left bundle branch. Diagnosis Diagnostic criteria: Clinically, bifascicular block presents with one of two ECG patterns: Right bundle branch block (RBBB) with left anterior fascicular block (LAFB), manifested as left axis deviation (LAD). RBBB and left posterior fascicular block (LPFB), manifested as right axis deviation The electrical axis of the heart is the net direction in which the wave of depolarization travels. It is measured using an ele ...
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Heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to the lungs. In humans, the heart is approximately the size of a closed fist and is located between the lungs, in the middle compartment of the chest. In humans, other mammals, and birds, the heart is divided into four chambers: upper left and right atria and lower left and right ventricles. Commonly the right atrium and ventricle are referred together as the right heart and their left counterparts as the left heart. Fish, in contrast, have two chambers, an atrium and a ventricle, while most reptiles have three chambers. In a healthy heart blood flows one way through the heart due to heart valves, which prevent backflow. The heart is enclosed in a protective sac, the pericardium, which also contains a small amount of fluid. The wall ...
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Fascicle
Fascicle or ''fasciculus'' may refer to: Anatomy and histology * Muscle fascicle, a bundle of skeletal muscle fibers * Nerve fascicle, a bundle of axons (nerve fibers) ** Superior longitudinal fasciculus *** Arcuate fasciculus ** Gracile fasciculus ** Cuneate fasciculus ** Dorsal longitudinal fasciculus ** Medial longitudinal fasciculus ** Flechsig's fasciculus *Fascicular pattern of histopathologic architecture Botany * Fascicle (botany), a cluster of flowers or leaves, such as the bundles of the thin leaves (or needles) of pines * A discrete bundle of vascular tissue Other uses * ''Fasciculus'', a fossil comb jelly * ''Fasciculus Chemicus'', a 17th-century anthology of alchemical writings * Fascicle (book) In literature, a serial is a printing or publishing format by which a single larger work, often a work of narrative fiction, is published in smaller, sequential instalments. The instalments are also known as ''numbers'', ''parts'' or ''fascicl ...
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Electrical Conduction System Of The Heart
The cardiac conduction system (CCS) (also called the electrical conduction system of the heart) transmits the signals generated by the sinoatrial node – the heart's pacemaker, to cause the heart muscle to contract, and pump blood through the body's circulatory system. The pacemaking signal travels through the right atrium to the atrioventricular node, along the bundle of His, and through the bundle branches to Purkinje fibers in the walls of the ventricles. The Purkinje fibers transmit the signals more rapidly to stimulate contraction of the ventricles. The conduction system consists of specialized heart muscle cells, situated within the myocardium. There is a skeleton of fibrous tissue that surrounds the conduction system which can be seen on an ECG. Dysfunction of the conduction system can cause irregular heart rhythms including rhythms that are too fast or too slow. Structure Electrical signals arising in the SA node (located in the right atrium) stimulate the atr ...
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Right Bundle Branch Block
A right bundle branch block (RBBB) is a heart block in the right bundle branch of the electrical conduction system. During a right bundle branch block, the right ventricle is not directly activated by impulses travelling through the right bundle branch. The left ventricle, however, is still normally activated by the left bundle branch. These impulses are then able to travel through the myocardium of the left ventricle to the right ventricle and depolarize the right ventricle this way. As conduction through the myocardium is slower than conduction through the Bundle of His-Purkinje fibres, the QRS complex is seen to be widened. The QRS complex often shows an extra deflection that reflects the rapid depolarisation of the left ventricle followed by the slower depolarisation of the right ventricle. Incomplete right bundle branch block Incomplete right bundle branch block (IRBBB) is an conduction abnormality in the right bundle branch block. While a complete RBBB has a QRS duratio ...
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Left Anterior Fascicular Block
Left anterior fascicular block (LAFB) is an abnormal condition of the left ventricle of the heart, related to, but distinguished from, left bundle branch block (LBBB). It is caused by only the left anterior fascicle – one half of the left bundle branch being defective. It is manifested on the ECG by left axis deviation. It is much more common than left posterior fascicular block. Mechanism Normal activation of the left ventricle (LV) proceeds down the left bundle branch, which consist of three fascicles, the left anterior fascicle, the left posterior fascicle, and the septal fascicle. The posterior fascicle supplies the posterior and inferoposterior walls of the LV, the anterior fascicle supplies the upper and anterior parts of the LV and the septal fascicle supplies the septal wall with innervation. LAFB — which is also known as left anterior hemiblock (LAHB) — occurs when a cardiac impulse spreads first through the left posterior fascicle, causing a delay in activation of ...
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Left Posterior Fascicular Block
A left posterior fascicular block (LPFB), also known as left posterior hemiblock (LPH), is a condition where the left posterior fascicle, which travels to the inferior and posterior portion of the left ventricle, does not conduct the electrical impulses from the atrioventricular node. The wave-front instead moves more quickly through the left anterior fascicle and right bundle branch, leading to a right axis deviation seen on the ECG. Definition The American Heart Association has defined a LPFB as: * Frontal plane axis between 90° and 180° in adults * rS pattern in leads I and aVL * qR pattern in leads III and aVF * QRS duration less than 120 ms The broad nature of the posterior bundle as well as its dual blood supply makes isolated LPFB rare. See also * Left bundle branch block * Left anterior fascicular block Left anterior fascicular block (LAFB) is an abnormal condition of the left ventricle of the heart, related to, but distinguished from, left bundle branch block (LBBB) ...
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Left Bundle Branch Block
Left bundle branch block (LBBB) is a conduction abnormality in the heart that can be seen on an electrocardiogram (ECG). In this condition, activation of the left ventricle of the heart is delayed, which causes the left ventricle to contract later than the right ventricle. Causes Among the causes of LBBB are: * Aortic stenosis * Dilated cardiomyopathy * Acute myocardial infarction * Extensive coronary artery disease * Primary disease of the cardiac electrical conduction system * Long standing hypertension leading to aortic root dilatation and subsequent aortic regurgitation * Lyme disease Mechanisms Slow or absent conduction through the left bundle branch means that it takes longer than normal for the left ventricle to fully depolarise. This can be due to a damaged bundle branch that is completely unable to conduct, but may represent intact conduction that is slower than normal. LBBB may be fixed, present at all times, but may be intermittent for example occurring only durin ...
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Bifurcation
Bifurcation or bifurcated may refer to: Science and technology * Bifurcation theory, the study of sudden changes in dynamical systems ** Bifurcation, of an incompressible flow, modeled by squeeze mapping the fluid flow * River bifurcation, the forking of a river into its tributaries * Bifurcation lake, a lake that flows into two different drainage basins * Bifurcated bonding, a single hydrogen atom participates in two hydrogen bonds Other uses * Bifurcation (law), the division of issues in a trial See also * Aortic bifurcation, the point at which the abdominal aorta bifurcates into the left and right common iliac arteries * Tracheal bifurcation, or the carina of trachea (Latin: ''bifurcatio tracheae'') * Bifurcation diagram * Bifurcate merging, a kinship system * False dilemma or bifurcation * Tongue bifurcation (other) * Fork (other) A fork is a utensil for eating and cooking. Fork may also refer to: Implements * Fork (road), a type of intersection where a ...
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Left Axis Deviation
In electrocardiography, left axis deviation (LAD) is a condition wherein the mean electrical axis of ventricular contraction of the heart lies in a frontal plane direction between −30° and −90°. This is reflected by a QRS complex positive in lead I and negative in leads aVF and II. There are several potential causes of LAD. Some of the causes include normal variation, thickened left ventricle, conduction defects, inferior wall myocardial infarction, pre-excitation syndrome, ventricular ectopic rhythms, congenital heart disease, high potassium levels, emphysema, mechanical shift, and paced rhythm. Symptoms and treatment of left axis deviation depend on the underlying cause. Defining left axis deviation Cardiac axis in electrocardiography represents the sum of depolarization vectors generated by individual cardiac myocytes. To interpret the cardiac axis, one has to determine the relationship between the QRS axis and limb leads of the ECG. Usually, left ventricles makes ...
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Right Axis Deviation
The electrical axis of the heart is the net direction in which the wave of depolarization travels. It is measured using an electrocardiogram (ECG). Normally, this begins at the sinoatrial node (SA node); from here the wave of depolarisation travels down to the apex of the heart. The hexaxial reference system can be used to visualise the directions in which the depolarisation wave may travel. On a hexaxial diagram (see figure 1): * If the electrical axis falls between the values of -30° to +90° this is considered normal. * If the electrical axis is between -30° to -90° this is considered left axis deviation. * If the electrical axis is between +90° to +180° this is considered right axis deviation (RAD). RAD is an ECG finding that arises either as an anatomically normal variant or an indicator of underlying pathology. Signs, symptoms and risk factors There are often no symptoms for RAD and it is usually found by chance during an ECG. Many of the symptoms exhibited by pati ...
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Syncope (medicine)
Syncope, commonly known as fainting, or passing out, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. It is caused by a decrease in blood flow to the brain, typically from low blood pressure. There are sometimes symptoms before the loss of consciousness such as lightheadedness, sweating, pale skin, blurred vision, nausea, vomiting, or feeling warm. Syncope may also be associated with a short episode of muscle twitching. Psychiatric causes can also be determined when a patient experiences fear, anxiety, or panic; particularly before a stressful event usually medical in nature. When consciousness and muscle strength are not completely lost, it is called presyncope. It is recommended that presyncope be treated the same as syncope. Causes range from non-serious to potentially fatal. There are three broad categories of causes: heart or blood vessel related; reflex, also known as neurally mediated; and orthos ...
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