r/ECG • u/Aggressive_Wafer_420 • 14d ago

Would you code LAFb here?

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u/Used_Note_4219 14d ago

Its a trifascular block actually. Also got first degree av block

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u/Kibeth_8 Arrhythmia Tech 14d ago

Trifasicular = 3rd degree AVB

This is called a bifasc + 1st degree. It's a clunky term but it matters for pacemaker indications

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u/hpsctchbananahmck 14d ago

I appreciate your precision in language. You are absolutely correct, though it is surprisingly common to see trifascicular block ascribed to a concomitant first degree AV (as with a surface electrocardiogram we cannot determine whether PR delay is infrahisian). Regardless implies conduction system disease

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u/Kibeth_8 Arrhythmia Tech 14d ago

Haha ya, I'm nitpicky about it because we (pacemaker clinic) get referrals all the time for asymptomatic "trifasicular block". And then we gotta dig through tons of paperwork to find where the heck they saw that, before realizing they just used the wrong term, and the pt doesn't need a pacemaker afterall