###Human: Do I need pacemaker based on my EKG reports? ###Assistant: Hello. I guess you mean LAFB and not LAPB. According to you, you already have RBBB and this time the EKG strip read LAFB. Many times the EKG strips read the EKG strip wrongly. You should believe in your cardiologist as humans are needed to interpret the EKG with some specific criteria, to fit the EKG as normal or some pathology. While LAFB stands for left anterior fascicular block, there is no term such as LAPB in my knowledge. The other term is LPFB, which stands for the left posterior fascicular block. The LPFB is extremely rare and usually occurs in isolation. It would be nice if you could post the picture of your EKG so that I could give a second opinion. Also when RBBB is present in combination with the other two (either LAFB or LPFB) is called bifascicular block. If the bifascicular block is present chronically in a patient it has a relatively low risk of progression to a high degree block.