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Accessory Atrioventricular Node with Properties of a Typical of a Typical Accessory Pathway:
Author(s) -
GOLLOB MICHAEL H.,
BHARATI SAROJA,
SWERDLOW CHARLES D.
Publication year - 2000
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 - 10.1111/j.1540-8167.2000.tb00073.x
Subject(s) - medicine , accessory pathway , cardiology , endocardium , atrioventricular node , tachycardia , ablation , catheter ablation
Accessory AV Node. We report an accessory AV node producing ventricular preexcitation and comprising the retrograde limb of AV reentrant tachycardia (AVRT). A 66‐year‐old man presented with an anteroseptal myocardial infarction and thereafter developed recurrent, drug‐refractory AVRT requiring multiple cardioversions. Electrophysiologic findings were typical for a concealed anteroseptal accessory pathway 0.5 cm anterior to the His bundle. The patient died of intractable heart failure after endocardial resection for a left ventricular aneurysm and coronary bypass grafting. Pathologic examination revealed a para‐Hisian accessory AV node connecting the right atrium to ventricular myocardium immediately anterior to the His bundle at a depth of 4 mm from the endocardium. No typical AV accessory pathway was found. This is the first report of an accessory AV node that participated in AVRT. It was deeper than typical radiofrequency catheter ablation lesions.