Left posterior fascicular block (LPFB) – The Premier EKG Resource for Medical Professionals

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Left posterior fascicular block (LPFB)

ECG Features

  • Mean ventricular (QRS) axis between +110° and +180° in adults with a mean QRS duration <120 ms
  • Typically rS complexes in I and aVL, along with qR complexes in II, aVF, and III
  • Absence of other causes of right axis deviation (e.g. lateral myocardial infarction, dextrocardia, right ventricular hypertrophy)

    • Note: The entire left bundle conduction system of the heart is made up of an left anterior and posterior fascicle. The left posterior fascicle supplies fibers to the posterior and inferior wall of the left ventricle. It is shorter and thicker than the left anterior fascicle and receives dual blood supply from both the left and right coronary arteries. Multivessel coronary artery disease is the most common cause of left posterior fascicular block.

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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.

Dr. Kashou continues to lead and teach weekly ECG sessions and weekend seminars for residents, nurses, ECG interpreting technicians, and physician assistants at the Mayo Clinic. He has been asked and is currently developing an ECG board review course for cardiology fellows. He has an online following of over 275,000 individuals and is the founder of the largest, fastest growing ECG community in the world. His clinical research focuses on developing innovative ECG algorithms that can be integrated and implemented into clinical practice.

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