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

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.