We report on a patient with the Wolff-Parkinson-White syndrome who temporarily exhibited a marked anterograde decremental conduction over a rapidly conducting accessory atrioventricular pathway after successful radiofrequency ablation. By recording the intracardiac electrogram via the ablation catheter placed at the successful ablation site, we were able to exclude the possibility of the occurrence of anterograde decremental conduction in the atrial or ventricular myocardium between the accessory pathway and the recording electrodes.
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Not Just a One-Way: Mahaim Accessory Pathway Concomitantly Supporting Orthodromic Atrioventricular Re-Entrant Tachycardia.
J Clin Med
December 2022
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Introduction: We report the case of a 41-year-old female with documented narrow QRS tachycardia. During electrophysiological study, both orthodromic and antidromic atrioventricular reentry tachycardia (AVRT) were demonstrated as well as short episodes of pre-excited atrial fibrillation. Programmed atrial stimulation resulted in decremental anterograde conduction on the AP, thus confirming an unexpected Mahaim accessory pathway (AP) diagnosis.
View Article and Find Full Text PDFA nodoventricular accessory pathway showing the degree of anterograde decremental conduction was more than the atrioventricular node.
View Article and Find Full Text PDFMinimally decremental atriofascicular accessory pathway with bidirectional conduction.
J Cardiovasc Electrophysiol
June 2021
Division of Cardiac ELectrophysiology, Cardiac Electrophysiology, Geisinger Heart Institute, Geisinger Commonwealth School of Medicine, Wilkes-Barre, Pennsylvania, USA.
Atriofacicular pathways of Mahaim type are typically decrementally conducting accessory pathways without retrograde conduction properties, located on the right ventricular free wall at the tricuspid annulus. We report a patient with an atriofascicular pathway with minimal anterograde decremental conduction. Both long and short V-H antidromic atriofascicular reentrant tachycardias were induced and mechanism confirmed with electrophysiologic testing.
View Article and Find Full Text PDFSimple Maneuver to Unmask a Nonmanifest Accessory Atrioventricular Pathway: A Case Report.
CJC Open
February 2021
Cardiology Department, Dijon University Hospital, Dijon, France.
We present the case of a 58-year-old patient admitted for wide QRS tachycardia (200 bpm). There was no delta wave on a 12-lead surface electrocardiogram during sinus rhythm. During the electrophysiological study, stimulation of the high right atrium and the proximal coronary sinus resulted in decremental anterograde conduction through the atrioventricular node, whereas pacing at the right ventricular apex led to retrograde conduction through the atrioventricular node.
View Article and Find Full Text PDFComparison of electrophysiological characteristics of right- and left-sided Mahaim-type accessory pathways.
J Cardiovasc Electrophysiol
February 2021
Department of Cardiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.
Aims: Mahaim-type accessory pathways (MAPs) are generally right-sided due to the embryological differentiation, but left-sided localization is also possible. This study aims to compare the clinical and electrophysiological characteristics of right- and left-sided MAPs.
Methods: Of 251 patients diagnosed with AP by electrophysiological study between November 2015 and February 2020, 12 patients with MAP were included (right sided n = 8, left sided n = 4).
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