Premium
Electrophysiologic Demonstration of an Atriofascicular Accessory Pathway
Author(s) -
KOU WILLIAM H.,
MORADY FRED,
BUITLEIR MICHAEL,
NELSON STEVEN D.
Publication year - 1988
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.1540-8159.1988.tb04538.x
Subject(s) - medicine , accessory pathway , cardiology , tachycardia , bundle of his , electrophysiology , atrioventricular block , qrs complex , left bundle branch block , atrium (architecture) , electrophysiologic study , electrical conduction system of the heart , electrocardiography , atrial fibrillation , catheter ablation , heart failure
Evidence of an atriofascicular accessory pathway has not been reported previously. In the patient presented in this case report, an electrophysiology study demonstrated a constant left bundle branch block QRS configuration despite varying degrees of ventricular preexcitation, in association with a constant atrioventricular interval during incremental atrial pacing and programmed atrial stimulation. The presence of an atrioventricular, nodoventricular, nodofascicular, and atrial‐His accessory pathway was ruled out. The findings are best explained by the presence of an underlying left bundle branch block and an atriofascicular accessory pathway connecting the atrium and right bundle. The atriofascicular accessory pathway was a passive bystander during an atrial tachycardia and was not directly involved in the generation of the tachycardia. To our knowledge, this is the first report of an atriofascicular accessory pathway.