Anterior MI, spreading to the septal leads.
I also don't think it quite makes the criteria for left anterior fascicular/hemiblock. It's technically suppose to be at least -30 degree I thought, and the morphology is qR in I, rS in III (and prossibly in all the inferior leads), and none of my books have said it, but I think it's done by exclusion of other causes of axis deviation like I know in the setting of left ventricular hypertrophy, they don't usually say left anterior fascicular block, at least in the books I've read.