American Journal of Emergency Medicine
Volume 27, Issue 4 , Pages 492-502, May 2009

Intraventricular conduction abnormality—an electrocardiographic algorithm for rapid detection and diagnosis

  • Daniel Garcia, MD

      Affiliations

    • Department of Emergency Medicine, University of Virginia, Charlottesville, VA 22908, USA
    • ,
  • Amal Mattu, MD

      Affiliations

    • Department of Emergency Medicine, University of Maryland, Baltimore, MD 21201, USA
    • ,
  • Christopher P. Holstege, MD

      Affiliations

    • Department of Emergency Medicine, University of Virginia, Charlottesville, VA 22908, USA
    • ,
  • William J. Brady, MD

      Affiliations

    • Department of Emergency Medicine, University of Virginia, Charlottesville, VA 22908, USA
    • Corresponding Author InformationCorresponding author.

Received 26 January 2008; accepted 27 January 2008.

Abstract 

Intraventricular conduction abnormalities are commonly seen on the electrocardiograms of patients in the emergency department population. The significance of such a finding can vary widely. When placed into clinical context, determination and description of an intraventricular conduction delay (IVCD) can assist in the management of a number of pathologies—directly cardiac and otherwise. The IVCDs discussed in this review include the unifascicular blocks (right bundle branch block [RBBB], left anterior fascicular block [LAFB], and left posterior fascicular block [LPFB]) and the bifascicular blocks (left bundle branch block, RBBB plus LAFB, and RBBB plus LPFB). After a review of these IVCDs, a simplified algorithm that will aid in the electrocardiographic diagnosis of these conduction abnormalities is presented.

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PII: S0735-6757(08)00149-6

doi:10.1016/j.ajem.2008.01.059

American Journal of Emergency Medicine
Volume 27, Issue 4 , Pages 492-502, May 2009

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