title: Ablating the ventricular insertion of atrio-fascicular Mahaim fiber: what selection criteria should we use?
abstract: We reported a patient who underwent RF ablation of the distal insertion of an atrio-fascicular accessory pathway with decremental properties because of inability to map a suitable potential alongside the tricuspid annulus. Small, discrete potentials resembling those of purkinje fiber were found at right ventricular apex, all these potentials showed early activation during tachycardia preceding the QRS onset of various degrees. Pace mapping helped to localize the presumed main distal insertion of the atrio-fascicular AP in a region where a damage of the His-purkinje system may ensue. This case report describes catheter ablation of an atriofascicular accessory pathway by targeting its distal (ventricular) insertion site.
authors.affiliation: Department of Cardiology, San Luca Hospital, Vallo della Lucania (SA), Italy, valentino.ducceschi@tin.it
authors.forename: Valentino
authors.initials: V
authors.lastname: Ducceschi
authors.forename: Raffaele
authors.initials: R
authors.lastname: Vitale
authors.forename: Luca
authors.initials: L
authors.lastname: Ottaviano
authors.forename: Ewa Anna
authors.initials: EA
authors.lastname: Sokola
authors.forename: Raffaele
authors.initials: R
authors.lastname: Sangiuolo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gregorio
mesh_terms: D000328:Adult; D018780:Body Surface Potential Mapping / Q000379:methods; D017115:Catheter Ablation / Q000379:methods; D006325:Heart Atria / Q000002:abnormalities* / Q000601:surgery*; D006329:Heart Conduction System / Q000002:abnormalities* / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D011227:Pre-Excitation, Mahaim-Type / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome