[Electrophysiological study of 2 cases of ventricular pre-excitation compatible with the presence of Mahaim's fibers].
Report of two cases of ventricular pre-excitation in which the presence of Mahaim's fibres was suggested by the electro-physiological studies. In both cases, the short-circuit of the His bundle was responsible for the abnormally short HV interval. In a patient, atrial acceleration induced an increase of rh at first, related to an A-V delay without HV variation. For a cycle of 360 ms, HV lengthened suddenly from 15 to 40 ms while QRS changed configuration, which is in favour of a functional exclusion of an accessory pathway. Combination with the pre-excitation of a left bundle-branch block complicated, in this case, the problems of identification. The other case responded also to cardiac pacing by an increase of the A-V delay due mainly to intra-nodal conduction slowing. In the same time HV increases from 20 to 30 ms (for a cycle change from 480 to 315 ms) and the delta wave decreased progressively. For a higher rate there was a 2:1 A-V block proximal to H. The extrastimulus method produced initially the same results. On the contrary, when the coupling-interval decreased to 290 ms, HV increased suddenly from 25 to 45 ms, with disappearance of the pre-excitation pattern. At a still shorter interval, HV shortened again (25 ms) in parallel with a marked lengthening of the A-V nodal conduction times, thus revealing a "gap" phenomenon of the accessory pathway.
D000293:Adolescent; D000328:Adult; D001281:Atrial Fibrillation / Q000503:physiopathology; D002036:Bundle of His / Q000503:physiopathology*; D002037:Bundle-Branch Block / Q000503:physiopathology; D006328:Cardiac Catheterization; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D013614:Tachycardia, Paroxysmal / Q000503:physiopathology; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology*
Etude électrophysiologique de deux cas de préexcitation ventriculaire compatibles avec la présence de fibres de Mahaim