title: Directions of atrial excitation wavefront influenced antegrade conduction of manifest accessory atrioventricular pathway: a case report.
abstract: We report a case of left accessory atrioventricular pathway (AP) which antegrade conduction was manifest during pacing from the anterior site of the atrial insertion, but absent during pacing from the posterior site. Infusion of adenosine triphosphate during pacing from the posterior site induced a conduction block of atrioventricular node without affecting the persistent antegrade conduction block of the AP. These findings suggested that the different response of the AP according to the directional change of atrial conduction was not due to a "linking" phenomenon, but may relate to the impedance mismatch because of an oblique fashion of the pathway.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Aiba
authors.forename: Takashi
authors.initials: T
authors.lastname: Kurita
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Satomi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Taguchi
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.forename: Naohiko
authors.initials: N
authors.lastname: Aihara
authors.forename: Shiro
authors.initials: S
authors.lastname: Kamakura
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria; D006327:Heart Block / Q000503:physiopathology; D006329:Heart Conduction System / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology*