2025 ICD-10-CM code I45.3
(Active) Effective Date: N/A Revision Date: N/A Diseases of the circulatory system - Other forms of heart disease (I30-I5A) Diseases of the circulatory system (I00-I99) Feed
Trifascicular block is a type of heart block affecting the heart's electrical conduction system, specifically the three fascicles of the bundle branches that carry electrical signals from the atrioventricular node to the ventricles.
Medical necessity for interventions like pacemaker implantation is established by the presence of a symptomatic trifascicular block or evidence of significant conduction disturbances at risk of progressing to complete heart block.The decision for treatment is based on clinical presentation and findings from ECG and other tests.
Diagnosis and management of trifascicular block typically involves a cardiologist. This may involve taking a detailed medical history, performing a physical examination, ordering an electrocardiogram (ECG), and potentially other investigations such as echocardiography or electrophysiology studies to determine the severity of the conduction disturbance and identify any underlying cause.Treatment strategies depend on the severity of the block and may range from close observation and medication adjustments to pacemaker implantation.
In simple words: A trifascicular block is a problem with the electrical signals in your heart. These signals control how fast your heart beats.In a trifascicular block, the signals don't travel through your heart normally, potentially causing your heart to beat too slowly.This can sometimes cause dizziness, fainting, or shortness of breath.Doctors use an ECG (electrocardiogram) to check for this condition and may recommend a pacemaker if necessary.
Trifascicular block is a cardiac conduction disorder characterized by impaired transmission of electrical impulses through the three fascicles of the bundle branches: the right bundle branch and the two fascicles of the left bundle branch (left anterior and left posterior fascicles).This disruption can lead to varying degrees of heart block, ranging from asymptomatic slowing of the heart rate to complete heart block, a life-threatening condition requiring immediate intervention.The diagnosis is typically made using electrocardiography (ECG), which reveals characteristic abnormalities in the electrical activity of the heart. The underlying causes can be diverse, including structural heart disease, electrolyte imbalances, medication side effects, and iatrogenic factors.
Example 1: A 70-year-old male with a history of coronary artery disease presents with syncope.ECG reveals a trifascicular block pattern.The patient undergoes electrophysiology studies to evaluate the extent of the block and confirm the diagnosis. A permanent pacemaker is implanted due to the high risk of complete heart block., A 65-year-old female with hyperkalemia develops a trifascicular block. ECG demonstrates RBBB and LAFB with prolonged PR interval.Correction of the hyperkalemia results in resolution of the trifascicular block., A 55-year-old male post myocardial infarction presents with symptomatic bradycardia. ECG shows evidence of trifascicular block with alternating RBBB and LBBB. He receives temporary pacing and is evaluated for permanent pacemaker implantation.
Detailed medical history including symptoms (e.g., syncope, dizziness, palpitations, shortness of breath), medication list, and past medical history (e.g., coronary artery disease, myocardial infarction, electrolyte imbalances).ECG demonstrating trifascicular block pattern (RBBB, LAFB/LPFB, and varying degrees of AV block).Results of any further investigations (e.g., echocardiography, electrophysiology study).
** Trifascicular block is a clinical diagnosis based on ECG findings and clinical presentation.The term is sometimes used loosely to describe various patterns of conduction defects involving the right bundle branch and left fascicles, which may or may not involve AV nodal disease.The treatment approach is highly individualized and requires careful consideration of the patient's specific clinical situation.
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- Specialties:Cardiology
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