Abstract
Although a trifascicular structure has been proposed for the left bundle branch, conduction delay in a third fascicle is rarely recognized. 1,2 This may be due to a lack of specific features for diagnosis of anterior conduction delay, 3 because identical patterns can be obtained with right ventricular hypertrophy or posterior myocardial infarction. 4 We present the stress test of a patient with critical coronary artery disease that exhibited ischemia and transient, complex conduction delay, manifested as prominent anterior forces followed by right bundle branch block (RBBB), with evolution of anteroseptal infarction.
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