A 90 year old lady with syncope.

'Trifasicular' block

The combination of RBBB, LAFB and long PR interval has been called 'trifasicular' block and implies that conduction is delayed in the third fascicle (in this case the left posterior fascicle) and a permanent pacemaker may be needed. However there are other causes of a long PR interval such as delayed conduction in the AV node or atrium so 'trifascicular block' is not a true ECG diagnosis.