Left Posterior Fascicular Block

aka Left Posterior Hemiblock

 

Findings:

1. vertical or rightward axis of at least 60 degrees with qR in II, III and aVF and R III always > R II
2. delayed intrinsicoid deflection in aVF > 45 ms, or slurred downstroke of R aVF and sometimes V6 also
3. often secondary T waves: negative in II, III and aVF and upright in 1 and aVL
4. other causes of right axis deviation must be excluded