Surface Mapping Characteristics of Left Fascicular Blocks
When Rosenbaum et al. (1968) decided upon the criteria for the diagnosis of left anterior hemiblocks, he remarked that it was difficult to draw a precise dividing line between ordinary left axis deviation and left axis deviation due to left anterior hemiblocks. The existence of different degrees of left anterior hemiblocks has been recognized from the outset: different left anterior hemiblock patterns may occur, for example in the same patient, during aberrant ventricular conduction of premature supraventricular beats induced experimentally by programmed atrial stimulation (Kulbertus et al., 1976). As suggested by Durrer et al. (1966) the forme fruste endocardial cushion defect can produce left axis deviation probably due to abnormal development of the conducting system. The left posterior hemiblock as well as the left septal fascicular block do not behave as clearcut phenomena, and the different authors agree on their deceptive and non-specific nature (Rosenbaum et al., 1972); however in the majority of cases the histological findings are consistent with the known electrocardiographic criteria (Demoulin and Kulbertus, 1972).
KeywordsAnterior Chest Wall Main Maximum Posterior Chest Wall Left Axis Deviation Electrocardiographic Pattern
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