Left bundle branch Pacing ecg, Summaries of Cardiology

Left bundle branch Pacing ecg analysis

Typology: Summaries

2025/2026

Uploaded on 06/13/2026

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12-Lead ECG Differentiation: LBB vs Fascicular vs
Deep Septal Pacing
1. True Left Bundle Branch (LBB) Pacing
• QRS: <120–130 ms
• V1: rSR / qR / R pattern
• V6: Tall R, no S
• Axis: Normal
• V6 RWPT: <80 ms
• Early transition (V2–V3)
2. Posterior Fascicular Pacing
• Axis: Left axis deviation
• Inferior leads: Negative
• V1: RBBB pattern
• QRS: 110–140 ms
• V6 RWPT: >80 ms
3. Anterior Fascicular Pacing
• Axis: Right axis deviation
• Inferior leads: Positive
• V1: RBBB pattern
• QRS: Mildly prolonged
• V6 RWPT: Slightly delayed
4. Deep Septal Pacing
• QRS: >130–150 ms
• V1: QS / rS
• V6: Broad R
• Axis: Variable
• V6 RWPT: >90–100 ms
• Late transition (V4–V6)
Summary Table
Feature True LBB Posterior Fascicle Anterior Fascicle Deep Septal
Axis Normal Left Right Variable
QRS Narrow Mild wide Mild wide Wide
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12-Lead ECG Differentiation: LBB vs Fascicular vs

Deep Septal Pacing

1. True Left Bundle Branch (LBB) Pacing

  • QRS: <120–130 ms
  • V1: rSR′ / qR / R pattern
  • V6: Tall R, no S
  • Axis: Normal
  • V6 RWPT: <80 ms
  • Early transition (V2–V3)

2. Posterior Fascicular Pacing

  • Axis: Left axis deviation
  • Inferior leads: Negative
  • V1: RBBB pattern
  • QRS: 110–140 ms
  • V6 RWPT: >80 ms

3. Anterior Fascicular Pacing

  • Axis: Right axis deviation
  • Inferior leads: Positive
  • V1: RBBB pattern
  • QRS: Mildly prolonged
  • V6 RWPT: Slightly delayed

4. Deep Septal Pacing

  • QRS: >130–150 ms
  • V1: QS / rS
  • V6: Broad R
  • Axis: Variable
  • V6 RWPT: >90–100 ms
  • Late transition (V4–V6)

Summary Table

Feature True LBB Posterior Fascicle Anterior Fascicle Deep Septal Axis Normal Left Right Variable QRS Narrow Mild wide Mild wide Wide

V1 RBBB pattern RBBB pattern RBBB pattern QS/rS

V6 RWPT <80 ms 80–90 ms 80–90 ms >90–100 ms