title: 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.
abstract: 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.
authors.affiliation: Division of Cardiology, Lovelace Medical Center, Albuquerque, New Mexico 87108, USA.
authors.forename: C T
authors.initials: CT
authors.lastname: Johnson
authors.forename: C
authors.initials: C
authors.lastname: Brooks
authors.forename: J
authors.initials: J
authors.lastname: Jaramillo
authors.forename: S
authors.initials: S
authors.lastname: Mickelsen
authors.forename: F M
authors.initials: FM
authors.lastname: Kusumoto
mesh_terms: 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