ECG review. As a routine health checkup!

Thank you for sharing the ECG. Your ECG shows a right bundle branch block together with a left anterior fascicular block. When these two appear together, it is called a bifascicular block. The heart's electrical signal reaches the pumping chambers through three main conduction branches. In your ECG, two of them are conducting slowly, so the signal is travelling mainly through the third. At 74 this is a fairly common finding. It usually comes from age-related wear of the heart's conduction tissue, and many people live with it for years without any problem. What decides the next step is whether you have symptoms. If you have had any fainting, blackout or near-fainting spells, this finding needs further evaluation. A cardiologist will want to see whether the conduction system is failing intermittently. That is usually checked with longer rhythm monitoring such as a Holter, along with an echocardiogram. Some patients in this situation end up needing a pacemaker. If you have chest pain or chest discomfort on exertion, remember that a resting ECG can be misleadingly normal in some patients. It records only a few seconds of the heart at rest, so on its own it cannot rule out coronary artery disease. Chest pain needs a proper cardiology evaluation whatever the ECG shows. If you have no symptoms at all, nothing else needs to be done for this ECG finding. Guidelines do not recommend a pacemaker or any treatment for bifascicular block in someone who is well.

No symptoms: nothing more is needed for this ECG. Any fainting, near-fainting or chest pain: see a cardiologist in person for evaluation.

Keep a copy of this ECG for future comparison. Sudden fainting, severe dizziness, a very slow pulse, or chest pain lasting more than 10 to 15 minutes means going to an emergency straight away.