Heart rhythm · 2026
Left septal fascicular block-like ECG pattern in acute coronary syndrome: Clinical presentation and prognostic implications.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Matsui Yuko, Higuchi Satoshi, Takehisa Kao, Horiuchi Mitsuru, Kikuchi Kensuke, Watanabe Shonosuke, Kani Kunihiro, Hasegawa Shun, Yazaki Kyoichiro, Saito Takashi, Yagishita Daigo, Mori Fumiaki, Nogami Akihiko, Scheinman Melvin M, Yamaguchi Junichi, Shoda Morio
Аннотация
BACKGROUND: The left bundle branch has traditionally been described as consisting of anterior and posterior fascicles, but increasing attention has focused on a third component, the left septal fascicle. Electrocardiographic (ECG) findings consistent with left septal fascicular block (LSFB) have been described; however, their clinical significance in acute coronary syndrome (ACS) remains uncertain.
OBJECTIVE: This study aimed to characterize the clinical presentation associated with a transient LSFB-like ECG pattern in patients with ACS undergoing emergency percutaneous coronary intervention (PCI).
METHODS: Among 789 consecutive patients with ACS treated with emergent PCI between 2017 and 2024, we identified patients with a transient LSFB-like ECG pattern, defined by a marked increase in anterior QRS forces (R-wave amplitude ≥15 mm in lead V2) during the acute ischemic phase with attenuation after revascularization. Patients with other causes of prominent anterior QRS forces were excluded. Clinical, angiographic, and outcome data were retrospectively analyzed.
RESULTS: A transient LSFB-like ECG pattern was identified in 8 patients (1.0%), resolving after reperfusion in all cases. All culprit lesions were located in the proximal left anterior descending artery (LAD) at or proximal to the first septal branch. Ventricular fibrillation occurred in 3 patients (37.5%) before PCI. No recurrence of the LSFB-like pattern was observed on follow-up ECG.
CONCLUSION: A transient LSFB-like ECG pattern was uncommon but associated with proximal LAD involvement in this ACS cohort. Recognition of this dynamic ECG pattern may help identify septal ischemia and proximal LAD lesions. Further studies are warranted to refine ECG definitions and to clarify the clinical implications of LSFB-like patterns.
OBJECTIVE: This study aimed to characterize the clinical presentation associated with a transient LSFB-like ECG pattern in patients with ACS undergoing emergency percutaneous coronary intervention (PCI).
METHODS: Among 789 consecutive patients with ACS treated with emergent PCI between 2017 and 2024, we identified patients with a transient LSFB-like ECG pattern, defined by a marked increase in anterior QRS forces (R-wave amplitude ≥15 mm in lead V2) during the acute ischemic phase with attenuation after revascularization. Patients with other causes of prominent anterior QRS forces were excluded. Clinical, angiographic, and outcome data were retrospectively analyzed.
RESULTS: A transient LSFB-like ECG pattern was identified in 8 patients (1.0%), resolving after reperfusion in all cases. All culprit lesions were located in the proximal left anterior descending artery (LAD) at or proximal to the first septal branch. Ventricular fibrillation occurred in 3 patients (37.5%) before PCI. No recurrence of the LSFB-like pattern was observed on follow-up ECG.
CONCLUSION: A transient LSFB-like ECG pattern was uncommon but associated with proximal LAD involvement in this ACS cohort. Recognition of this dynamic ECG pattern may help identify septal ischemia and proximal LAD lesions. Further studies are warranted to refine ECG definitions and to clarify the clinical implications of LSFB-like patterns.