Transient left septal fascicular block in the setting of acute coronary syndrome associated with giant slurring variant J-wave.
Andrés Ricardo Pérez RieraRaimundo Barbosa-BarrosWallam Lima AragãoRodrigo Daminello-RaimundoLuiz Carlos de AbreuJoseane Elza Tonussi Mendes Rossette do ValleIsabel Cristina Esposito SorpresoKjell NikusPublished in: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc (2018)
We report a case of acute coronary syndrome with transient prominent anterior QRS forces (PAF) caused by proximal subocclusion of the left anterior descending (LAD) coronary artery before the first septal perforator branch. The ECG change indicates left septal fascicular block (LSFB) with associated slurring-type giant J-wave. Currently, this J-wave variant is considered as a lambda-like wave or QRS-ST-T "triangulation". Its presence is indicative of poor prognosis because of the risk for cardiac arrest as a consequence of ventricular tachycardia/ventricular fibrillation (VT/VF).
Keyphrases
- acute coronary syndrome
- poor prognosis
- cardiac arrest
- coronary artery
- long non coding rna
- hypertrophic cardiomyopathy
- percutaneous coronary intervention
- antiplatelet therapy
- heart failure
- left ventricular
- cerebral ischemia
- pulmonary artery
- cardiac resynchronization therapy
- cardiopulmonary resuscitation
- heart rate
- coronary artery disease