Dual Conduction in a Mahaim Fiber

The case of an 8‐year‐old girl with incessant nonsustained left bundle branch block‐like tachycardia refractory to antiarrhythmic drug therapy is reported. Electrophysiologic study revealed the presence of a right‐sided accessory atriofascicular pathway. Episodes of nonsustained tachycardia were fou...

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Published inJournal of cardiovascular electrophysiology Vol. 15; no. 10; pp. 1212 - 1215
Main Authors STERNICK, EDUARDO BACK, SOSA, EDUARDO A., SCANAVACCA, MAURÍCIO I., WELLENS, HEIN J.J.
Format Journal Article
LanguageEnglish
Published 350 Main Street , Malden , MA 02148‐5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK Blackwell Science Inc 01.10.2004
Subjects
Bundle-Branch Block - etiology
Child
dual pathways
Electrocardiography
Female
Heart Conduction System - abnormalities
Humans
Mahaim fiber
tachycardia
Tachycardia - etiology
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Summary:The case of an 8‐year‐old girl with incessant nonsustained left bundle branch block‐like tachycardia refractory to antiarrhythmic drug therapy is reported. Electrophysiologic study revealed the presence of a right‐sided accessory atriofascicular pathway. Episodes of nonsustained tachycardia were found to be based upon a dual response in AV conduction over the Mahaim fiber to one P wave. No reentrant tachycardia could be induced. The arrhythmia was cured by catheter ablation targeting a Mahaim potential at the right lateral tricuspid annulus. The findings can be explained by longitudinal dissociation in a single Mahaim fiber, a fiber distally diverging into two fibers with different conduction times, or (less likely) two closely located Mahaim fibers with different conduction times.
Bibliography:Manuscript received 23 January 2004; Revised manuscript received 5 March 2004; Accepted for publication 11 March 2004.
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ISSN:1045-3873
1540-8167
DOI:10.1046/j.1540-8167.2004.04036.x