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Wide QRS Supraventricular Tachycardia Due to Coexisting Mahaim and Kent Pathways
Author(s) -
SETHI KAMAL K.,
JAISHANKAR S.,
GUPTA M. P.
Publication year - 1985
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1985.tb05858.x
Subject(s) - medicine , accessory pathway , cardiology , tachycardia , atrioventricular node , reentry , orthodromic , intracardiac injection , right bundle branch block , electrical conduction system of the heart , qrs complex , supraventricular tachycardia , anatomy , electrocardiography , catheter ablation , electrophysiology , atrial fibrillation
In two patients with Wolff‐Parkinson‐White syndrome, we observed the unusual coexistence of functional Mahaim and accessory atrioventricular pathways. In the first patient, three types of reciprocating tachycardia were demonstrable: (1) anterograde conduction over the atrioventricular (AV) node with right bundle branch block (RBBB) and retrograde conduction via a right‐sided atrioventricular accessory pathway; (2) anterograde conduction through the AV node with RBBB and retrograde conduction via two (right‐sided and septal) anomalous pathways; and (3) anterograde conduction through nodoventricular fibers and retrograde conduction over a right‐sided accessory pathway. In the second patient the reentry circuit was comprised of AV node fasciculoventricular fiber in an anterograde direction and a right‐sided accessory pathway in a retrograde direction. We believe this to be the first report of triple accessory pathways, consisting of two atrioventricular and one nodoventricular connection, demonstrated by intracardiac electrophysiologic study.