Bifascicular and trifascicular block 

In this video, I give a 5-minute run-down of how to spot bifascicular block and trifascicular block. Bifascicular block is the combination of right bundle branch block (RBBB) with axis deviation signifying left anterior fascicular block or left posterior fascicular block. Trifascicular block is a famous misnomer! There isn't a third fascicle blocked (that would be complete heart block). There's AV block. You need to spot this abnormality to identify patients who may need a pacemaker. I'll show you the simple system to make sure you NEVER MISS it!