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Abstract Objective To study the characteristics of Electrovectorgrapy (VCG) and Electrocardiogram (ECG) of left anterior fascicular block (LAFB) combined with concealed right bundle branch block (cRBBB). Methods 41 cases with LAFB and QRS duration≥0.12s were enrol ed and underwent electrovectorgraphy examination. They were divided into left ventricular hypertrophy(LVH) group(n=21)and non- LVH group(n=20) based on the results of echocardiograpy. LVH group was divided into supgroup A with LAFB and subgroup B with both LAFB and cRBBB. Results In non- LVH group, the terminal force of QRS loop was shifting to the right and posterosuperiorly, SV5、V6 widened with S/r duration ratio >1. In subgroup A, QRS loop shifted toward the left and posterosuperiorly with increased amplitude. In subgroup B, QRS loop shifted toward the left and posterosuperiorly or posteroinferiorly with increased amplitude. QRS duration on ECG was significantly longer(154.1vs 128.89ms, P<0.01) and S/r duration ratio in lead V5-6 was significantly larger(1.90±1.07 vs 1.41±0.51ms, P<0.05) in subgroup B than in subgroup A. Conclusion Concealed RBBB may be considered when QRS duration is≥0.12s with S/r duration ratio>1 in lead V5-6 in the present of LAFB.
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