Transient left septal fascicular block in the setting of acute coronary syndrome associated with giant slurring variant J-wave

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
Andrés Ricardo Pérez-RieraKjell Nikus

Abstract

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).

References

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May 6, 2004·Journal of Electrocardiology·Andrés Ricardo Pérez RieraPaulo Jorge Moffa
May 9, 2008·The New England Journal of Medicine·Michel HaïssaguerreJacques Clémenty
May 9, 2008·The New England Journal of Medicine·Gi-Byoung NamCharles Antzelevitch
Jul 25, 2008·Journal of Electrocardiology·Andrés Ricardo Pérez RieraAntoni Bayes de Luna
Nov 18, 2009·The New England Journal of Medicine·Jani T TikkanenHeikki V Huikuri
Nov 3, 2015·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Andrés Ricardo Pérez-RieraAdrian Baranchuk
Sep 19, 2017·Journal of Electrocardiology·Andrés Ricardo Pérez-RieraLuiz Carlos de Abreu

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Citations

Oct 9, 2018·Clinical Cardiology·Andrés R Pérez-RieraKjell Nikus
Sep 17, 2020·Arquivos brasileiros de cardiologia·Andrés Ricardo Pérez-RieraKjell Nikus
Jul 16, 2021·Journal of Electrocardiology·Andreas Y AndreouLida Efstathia Koskina

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