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Left Posteroseptal Mahaim Fiber Associated with Marked Longitudinal Dissociation
Author(s) -
TADA HIROSHI,
NOGAMI AKIHIKO,
NAITO SHIGETO,
OSHIMA SHIGERU,
TANIGUGHI KOICHI,
KUTSUMI YASUNORI
Publication year - 1999
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.1540-8159.1999.tb00393.x
Subject(s) - medicine , cardiology , ablation , mitral annulus , catheter ablation , qrs complex , radiofrequency ablation , reentry , blood pressure , diastole
We report a patient who underwent radiofrequency catheter ablation of a left posteroseptal atrioventricular (AV) Mahaim fiber with a marked longitudinal dissociation. During atrial pacing, Wenckebach‐type atrioventricular block over the accessory pathway was observed with progressive preexcitation and no change in polarity of the delta waves. The AV conduction curve was discontinuous, with a distinct “jump‐up” in local AV conduction time of 84 ms. The earliest ventricular activation was recorded from the posteroseptal portion of the mitral annulus, and the unipolar electrogram from a distal electrode had a high, steep deflection with uniphasic QS‐like activity with 62 ms of local AV conduction time.