The History of Left Septal Fascicular Block: Chronological Considerations of a Reality Yet to be Universally Accepted
There are several papers in literature that prove in a conclusive and incontestable way, that the left branch of the His bundle, in most instances (85% of the cases) splits into three fascicles of variable morphological pattern, and not into two: left anterior fascicle (LAF), left posterior fascicle...
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| Format: | Article |
| Language: | English |
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Elsevier
2008-04-01
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| Series: | Indian Pacing and Electrophysiology Journal |
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| Online Access: | http://www.ipej.org/0802/riera2.htm |
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| author | Andres Ricardo Perez Riera Augusto Hiroshi Uchida Edgardo Schapachnik Sergio Dubner Li Zhang Celso Ferreira Filho Dardo E. Ferrara Antoni Bayes de Luna Paulo Jorge Moffa |
| author_facet | Andres Ricardo Perez Riera Augusto Hiroshi Uchida Edgardo Schapachnik Sergio Dubner Li Zhang Celso Ferreira Filho Dardo E. Ferrara Antoni Bayes de Luna Paulo Jorge Moffa |
| author_sort | Andres Ricardo Perez Riera |
| collection | DOAJ |
| description | There are several papers in literature that prove in a conclusive and incontestable way, that the left branch of the His bundle, in most instances (85% of the cases) splits into three fascicles of variable morphological pattern, and not into two: left anterior fascicle (LAF), left posterior fascicle (LPF), and left septal fascicle (LSF). The abovementioned papers have anatomical, histological, anatomo-pathological, electrocardiographic, and vectocardiographic, body surface potential mapping or ECG potential mapping and electrophysiological foundation. Additionally, the mentioned papers have been performed both in animal models (dogs) and in the human heart. Several clinical papers have shown that the left septal fascicular block (LSFB) may occur intermittently or transitorily as a consequence of a temporary dromotropic alteration, constituting an aberrant ventricular conduction, rate-dependent or by the application of atrial extra-stimuli, or naturally during the acute phase of infarction when this involves the anterior descending artery, before the septal perforating artery that supplies the central portion of the septum, where the mentioned LSF runs. The ECG/VCG manifestation of LSFB consists in anterior shift of electromotive forces, known as Prominent Anterior Forces (PAF), which can hardly be diagnosed in the clinical absence of other causes capable of causing PAF, such as the normal variant by counterclockwise rotation of the heart on its longitudinal axis, in right ventricular enlargement, in the dorsal or lateral infarction of the new nomenclature, in type-A WPW, in CRBBB, and others. In this historical manuscript, we review in a sequential fashion, the main findings that confirmed the unequivocal existence of this unjustifiably "forgotten" dromotropic disorder. In the developed countries, its most important cause is coronary insufficiency, particularly the proximal involvement of the left anterior descending coronary artery, and in Latin America, Chagas disease. |
| first_indexed | 2024-12-13T21:38:18Z |
| format | Article |
| id | doaj.art-3c24653fa68f46ae9f84080129aa730e |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-12-13T21:38:18Z |
| publishDate | 2008-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-3c24653fa68f46ae9f84080129aa730e2022-12-21T23:30:36ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922008-04-0182114128The History of Left Septal Fascicular Block: Chronological Considerations of a Reality Yet to be Universally AcceptedAndres Ricardo Perez RieraAugusto Hiroshi UchidaEdgardo SchapachnikSergio DubnerLi ZhangCelso Ferreira FilhoDardo E. FerraraAntoni Bayes de LunaPaulo Jorge MoffaThere are several papers in literature that prove in a conclusive and incontestable way, that the left branch of the His bundle, in most instances (85% of the cases) splits into three fascicles of variable morphological pattern, and not into two: left anterior fascicle (LAF), left posterior fascicle (LPF), and left septal fascicle (LSF). The abovementioned papers have anatomical, histological, anatomo-pathological, electrocardiographic, and vectocardiographic, body surface potential mapping or ECG potential mapping and electrophysiological foundation. Additionally, the mentioned papers have been performed both in animal models (dogs) and in the human heart. Several clinical papers have shown that the left septal fascicular block (LSFB) may occur intermittently or transitorily as a consequence of a temporary dromotropic alteration, constituting an aberrant ventricular conduction, rate-dependent or by the application of atrial extra-stimuli, or naturally during the acute phase of infarction when this involves the anterior descending artery, before the septal perforating artery that supplies the central portion of the septum, where the mentioned LSF runs. The ECG/VCG manifestation of LSFB consists in anterior shift of electromotive forces, known as Prominent Anterior Forces (PAF), which can hardly be diagnosed in the clinical absence of other causes capable of causing PAF, such as the normal variant by counterclockwise rotation of the heart on its longitudinal axis, in right ventricular enlargement, in the dorsal or lateral infarction of the new nomenclature, in type-A WPW, in CRBBB, and others. In this historical manuscript, we review in a sequential fashion, the main findings that confirmed the unequivocal existence of this unjustifiably "forgotten" dromotropic disorder. In the developed countries, its most important cause is coronary insufficiency, particularly the proximal involvement of the left anterior descending coronary artery, and in Latin America, Chagas disease.http://www.ipej.org/0802/riera2.htmLeft Hissian intraventricular systemFascicular blocksLeft Septal Fascicular BlockHemiblocks. |
| spellingShingle | Andres Ricardo Perez Riera Augusto Hiroshi Uchida Edgardo Schapachnik Sergio Dubner Li Zhang Celso Ferreira Filho Dardo E. Ferrara Antoni Bayes de Luna Paulo Jorge Moffa The History of Left Septal Fascicular Block: Chronological Considerations of a Reality Yet to be Universally Accepted Indian Pacing and Electrophysiology Journal Left Hissian intraventricular system Fascicular blocks Left Septal Fascicular Block Hemiblocks. |
| title | The History of Left Septal Fascicular Block: Chronological Considerations of a Reality Yet to be Universally Accepted |
| title_full | The History of Left Septal Fascicular Block: Chronological Considerations of a Reality Yet to be Universally Accepted |
| title_fullStr | The History of Left Septal Fascicular Block: Chronological Considerations of a Reality Yet to be Universally Accepted |
| title_full_unstemmed | The History of Left Septal Fascicular Block: Chronological Considerations of a Reality Yet to be Universally Accepted |
| title_short | The History of Left Septal Fascicular Block: Chronological Considerations of a Reality Yet to be Universally Accepted |
| title_sort | history of left septal fascicular block chronological considerations of a reality yet to be universally accepted |
| topic | Left Hissian intraventricular system Fascicular blocks Left Septal Fascicular Block Hemiblocks. |
| url | http://www.ipej.org/0802/riera2.htm |
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