Left anterior fascicular block (LAFB) – The Premier EKG Resource for Medical Professionals

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Left anterior fascicular block (LAFB)

ECG Features

  • Mean ventricular (QRS) axis between -45° and -90° in adults with a mean QRS duration <120 ms
  • Typically qR complexes in I and aVL, along with rS complexes in II, aVF, and III
  • qR pattern in aVL with >45 ms delay from beginning of QRS complex to peak of R wave
  • Absence of other causes of left axis deviation (e.g. inferior myocardial infarction, left ventricular hypertrophy)
  • Note: The entire left bundle conduction system of the heart is made up of a left anterior and posterior fascicle. The left anterior fascicle supplies fibers to the anterior and lateral walls of the left ventricle.
  • Note: The above criteria do not apply to patients with congenital heart disease in whom left axis deviation is present in infancy.

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Dr. Anthony Kashou (The EKG Guy) is a physician resident at the Mayo Clinic in Rochester, Minnesota. He is on a mission to transform ECG education and filling the gap exists around the world. Dr. Kashou has taught and developed curriculum for medical students, including 500+ lectures and 100+ hours of adult and pediatric ECG lessons.

At the Mayo Clinic, he pursues innovative ECG research and was awarded first place for his research at the Minnesota American College of Cardiology Conference 2018. His passion for medical education and innovation led to the development of EKG.MD, which provides a convenient and accessible forum to learn the fundamentals and foundations of ECG interpretation. He has also authored dozens of peer-reviewed articles for medical journals and textbooks, along with multiple ECG books for learners at all levels.

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