| Atriofascicular connection or a nodoventricular Mahaim fiber? Electrophysiologic elucidation of the pathway and associated reentrant circuit. | |
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MedLine Citation:
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PMID: 3127077 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Accessory pathways showing decremental properties and inserting into the right ventricle have been frequently described as "nodoventricular" or Mahaim pathways. However, conclusive evidence for a nodal origination of such pathways is lacking. The patient in this study had characteristics typical of such a pathway. Antegradely, the pathway showed decremental, nodelike conduction properties. With the aid of right bundle branch recordings, the pathway was demonstrated to insert directly into the right bundle branch. Atrioventricular reciprocating tachycardia could be readily initiated by atrial or ventricular pacing. The QRS morphology was normal during sinus rhythm and demonstrated a left bundle branch block pattern with normal axis during tachycardia. The reentrant circuit involved antegrade conduction over the accessory pathway and retrograde conduction via the bundle branches, His bundle, and the atrioventricular node. More significantly, late atrial stimuli delivered during tachycardia could preexcite the ventricle via the accessory pathway despite their inability to enter the atrioventricular node. Thus, the upper "turn around" of the reentrant circuit involved atrial tissue and the accessory pathway originated directly from the right atrium independent of the atrioventricular node. In view of these new findings and other recent observations during surgical resection of similar pathways, a reassessment of previous descriptions of "nodoventricular" fibers may be necessary. Many of these pathways may actually represent atriofascicular or atrioventricular connections with decremental properties. |
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Authors:
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P Tchou; M H Lehmann; M Jazayeri; M Akhtar |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Circulation Volume: 77 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1988 Apr |
Date Detail:
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Created Date: 1988-04-28 Completed Date: 1988-04-28 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 837-48 Citation Subset: AIM; IM |
Affiliation:
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Natalie and Norman Soref and Family Electrophysiology Laboratory, University of Wisconsin-Sinai Samaritan Medical Center, Milwaukee 53233. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Bundle-Branch Block / diagnosis Cardiac Pacing, Artificial Electrocardiography Electrophysiology Heart Conduction System / physiopathology* Humans Male Pre-Excitation Syndromes / diagnosis* Pre-Excitation, Mahaim-Type / diagnosis*, physiopathology Tachycardia, Atrioventricular Nodal Reentry / diagnosis* Tachycardia, Supraventricular / diagnosis* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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