Electrophysiological study and catheter ablation of a Mahaim fibre located at the mitral annulus–aorta junction

• Published in: Journal of interventional cardiac electrophysiology Vol. 23; no. 2; pp. 153 - 157
• Main Authors: Francia, P., Pittalis, M. C., Ali, H., Cappato, R.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.11.2008; Springer Nature B.V
• Subjects: Aorta, Thoracic - diagnostic imaging; Aorta, Thoracic - physiopathology; Aorta, Thoracic - surgery; Cardiac Pacing, Artificial; Cardiology; Case Report; Catheter Ablation; Coronary Angiography; Electrocardiography; Electrophysiologic Techniques, Cardiac; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Mitral Valve - diagnostic imaging; Mitral Valve - physiopathology; Mitral Valve - surgery; Pre-Excitation, Mahaim-Type - diagnostic imaging; Pre-Excitation, Mahaim-Type - physiopathology; Pre-Excitation, Mahaim-Type - surgery; Accessory pathway; Decremental conduction; Mitral annulus–aorta junction; Mahaim; Catheter ablation
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1007/s10840-008-9279-1

Accessory pathways with slow and anterograde decremental conduction (Mahaim fibres) are responsible for a minority of atrioventricular reentrant tachycardias. While usually located along the tricuspid annulus, left-sided Mahaim fibres have been occasionally reported. We here report on a unique case of radiofrequency catheter ablation of a Mahaim pathway located at the supero-septal aspect of the mitral annulus, in a region known as mitral annulus–aorta junction, between the right and left fibrous trigons. Electrophysiological properties and embryological implications of this unusual accessory pathway are discussed.