This is a nice, clear right bundle branch block pattern: wide QRS, supraventricular rhythm (NSR), and rSR' pattern in V1. Wide little s waves in Leads I and V6 are also diagnostic. The left axis deviation indicates a left anterior fascicular block, since there is no other apparent reason for the left axis deviation, such as pathological Q waves or LVH. Left anterior fascicular block is a diagnosis of exclusion, also considering that RBBB and LAFB are often seen together (bifascicular block), since the two fascicles have the same blood supply.
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