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All ECG 108

  1. Normal sinus rhythm
  2. First degree AV block
  3. Right bundle branch block
  4. Left anterior fascicular block

This combination of findings is termed a "trifascicular block" with the third fascicle referring to the AV node causing a first degree AV block. This does indeed put a patient at risk for a higher grade AV block in the future. Some observational series have seen that about 50% of patients with this ECG finding will need a permanent pacemaker at some point in their lifetime.

Related Topic Reviews: First Degree AV Block, Right Bundle Branch Block, Left Anterior Fascicular Block