A left free-wall, decrementally conducting, atrioventricular (Mahaim) fiber: diagnosis at electrophysiological study and radiofrequency catheter ablation guided by direct recording of a Mahaim potential.
A 64-year-old female with Wolff-Parkinson-White syndrome and an ECG demonstrating a right posterolateral accessory pathway was referred for electrophysiological study. During electrophysiological testing two AV pathways were identified: a right posterolateral pathway that displayed conventional electrophysiological properties: and a left free-wall pathway that conducted only anterogradely and demonstrated decremental properties. Two separate wide complex tachycardias were induced that utilized the left free-wall pathway anterogradely and either the AV node or the right posterolateral accessory pathway retrogradely. A discrete electrical potential on the free wall of the mitral annulus was identified during tachycardia and was utilized to facilitate mapping and ablation.
Johnson
C T
CT
Division of Cardiology, Lovelace Medical Center, Albuquerque, New Mexico 87108, USA.
Brooks
C
C
Jaramillo
J
J
Mickelsen
S
S
Kusumoto
F M
FM
D001283:Atrioventricular Node / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery