DR. G THE NP Lesson series

You’ve seen wide QRS patterns before… but not knowing if it’s a critical LBBB is where you can get it wrong when it matters most.

LBBBs, fascicular blocks, axis deviation, poor R wave progression — this is the territory where even experienced providers go quiet. Not after this course.

EKG 102 — Blocks, Part II

"Left bundle branch block." You've seen it. You've typed it. But could you explain exactly what's happening?

"Left anterior fascicular block." You may have read those words a hundred times and still felt like they were written in a language you never quite speak.

Here's the thing about left-sided blocks: they're not harder than right-sided ones. They just look harder because nobody ever drew you the picture. That's exactly what this course does — step by step, until it clicks.

Before

"LBBB noted. Will follow up." …and hoping nobody asks a follow-up question.

After

"This is a new LBBB. Given the context, here's what we need to do right now."

What you'll master in this course:

Left bundle branch block (LBBB)

Complete and incomplete, what they look like, why they look that way, and why a new LBBB is never just a footnote in your assessment.

Left anterior fascicular block (LAFB)

How to identify it by its axis deviation signature, widened QRS, and the potentially dangerous finding it can be linked to.

Left posterior fascicular block (LPFB)

The rarer, easily missed cousin. You'll know the criteria, the look, and when it actually matters.

Axis deviation

Left, right, extreme. How to determine axis quickly and what an abnormal one is pointing you toward before you read another finding.

Poor R wave progression

One of the most under-recognized patterns on a 12-lead. You'll know what it means, what causes it, and why it deserves more than a passing mention.

Patterns you'll recognize after this course:

Complete and incomplete LBBBs

Left anterior fascicular block

Left posterior fascicular block

Poor R wave progression

Axis deviation

Why this actually sticks

Most EKG education fails for the same reason.

It gives you information in a format your brain does not hold onto. You understand it while you are looking at it — and then lose it the moment you are on your own.

That is not a motivation problem or a repetition problem. It is a teaching problem. And until that changes, you will keep running into the same wall.

That is why this is taught differently. Concepts are broken down using simple visuals, analogies, and clinical stories that make the logic so clear you do not have to fight to remember it.

That is the difference between information that fades and understanding that stays with you every time a strip lands in your hands. Once you experience that, it is very hard to go back.

Not temporarily. Not when it is obvious.

Consistently.

And when that happens, something shifts:

	You stop forcing yourself to get through it.
	You stop rereading the same thing hoping it will finally click.
	You start seeing patterns without second-guessing.
	You start understanding what the heart is actually doing instead of trying to match it to something you memorized.
	For the first time, you feel what it is like to actually know what you are looking at.

This is for you if:

	You finished EKG 101 and want to complete the full bundle branch block picture
	You want to stop skimming over axis and poor R wave progression
	Left-sided blocks have always felt murkier than right-sided ones
	You're building a complete, systematic EKG skill set from the ground up

You’ve seen wide QRS patterns before… but not knowing if it’s a critical LBBB is where you can get it wrong when it matters most.

"Left-sided blocks aren't harder. They just needed someone to draw you the picture. That's what we're doing here." - Dr. G

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