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Fasciculoventricular Pathways:
Author(s) -
STERNICK EDUARDO BACK,
GERKEN LUIZ MÁRCIO,
VRANDECIC MÁRIO O.,
WELLENS HEIN J.J.
Publication year - 2003
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2003.03206.x
Subject(s) - medicine , orthodromic , accessory pathway , cardiology , catheter ablation , sinus rhythm , ventricle , tachycardia , ablation , atrioventricular reentrant tachycardia , electrical conduction system of the heart , anesthesia , electrocardiography , electrophysiology , atrial fibrillation
Fasciculoventricular tracts are considered a rare form of ventricular preexcitation. Few fasciculoventricular pathways have been reported, and none have been linked to a reentrant tachycardia. Methods and Results: Four patients with fasciculoventricular bypass tracts underwent electrophysiologic evaluation. Two patients had a single fasciculoventricular pathway, one that inserted anteroseptally and the other in the left ventricle. Two patients also had an AV bypass tract, with anterograde conduction over the fasciculoventricular pathway during orthodromic AV reentrant tachycardia. After ablation of the AV pathways, the ECG during sinus rhythm and the electrophysiologic study showed ventricular preexcitation due to a fasciculoventricular bypass tract inserting into the right ventricle. Adenosine triphosphate was helpful in the diagnostic process. Conclusion: Electrophysiologists should be able to make the differential diagnosis between a fasciculoventricular bypass tract and an anteroseptal accessory pathway to preclude potential harm to the AV conduction system if a fasciculoventricular pathway is targeted for catheter ablation. (J Cardiovasc Electrophysiol, Vol. 14, pp. ***‐***, October 2003)