Premium
A Left Free‐Wall, Decrementally Conducting, Atrioventricular (Mahaim) Fiber : Diagnosis at Electrophysiological Study and Radiofrequency Catheter Ablation Guided by Direct Recording of a Mahaim Potential
Author(s) -
JOHNSON C. TIMOTHY,
BROOKS CONNI,
JARAMILLO JOSEPH,
MICKELSEN STEVEN,
KUSUMOTO FRED M.
Publication year - 1997
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.1540-8159.1997.tb06089.x
Subject(s) - accessory pathway , medicine , electrophysiology , electrophysiology study , cardiology , tachycardia , catheter ablation , ablation , radiofrequency catheter ablation , anatomy
A 64‐year‐old female with Wolff‐Parkinson‐White syndrome and an ECG demonstrating a rigbt posterolateral accessory pathway was referred for electrophysiological study. During electrophysiological testing two AV pathways were identified: a right posterolateral pathway that displayed conventional electrophysiological properties: and a left free‐wall pathway tbat conducted only anterogradely and demonstrated decremental properties. Two separate wide complex tachycardias were induced that utilized the left free‐wall pathway anterogradely and either the AV node or the right posterolateral accessory pathway retrogradely. A discrete electrical potential on the free wall of the mitral an‐nulus was identified during tachycardia and was utilized to facilitate mapping and ablation.