Comparison of electrophysiological characteristics of right‐ and left‐sided Mahaim‐type accessory pathways

Aims Mahaim‐type accessory pathways (MAPs) are generally right‐sided due to the embryological differentiation, but left‐sided localization is also possible. This study aims to compare the clinical and electrophysiological characteristics of right‐ and left‐sided MAPs. Methods Of 251 patients diagnos...

Full description

Saved in:
Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2021-02, Vol.32 (2), p.360-369
Main Authors: Ozcan, Emin Evren, Turan, Oguzhan Ekrem, Akdemir, Baris, Inevi, Umut Dursun, Yilancioglu, Resit Yigit, Baskurt, Ahmet Anil, Alak, Cetin, Bayrak, Fatih
Format: Article
Language:English
Subjects:
Ablation
accessory pathway
Adenosine
atriofascicular
atrioventricular
Catheters
Coexistence
Conduction
decremental
Electrophysiological recording
left‐sided
Localization
Mahaim
Myocardium
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aims Mahaim‐type accessory pathways (MAPs) are generally right‐sided due to the embryological differentiation, but left‐sided localization is also possible. This study aims to compare the clinical and electrophysiological characteristics of right‐ and left‐sided MAPs. Methods Of 251 patients diagnosed with AP by electrophysiological study between November 2015 and February 2020, 12 patients with MAP were included (right sided n = 8, left sided n = 4). MAP was diagnosed if; (1) no retrograde conduction; (2) anterograde decremental conduction; (3) adenosine sensitivity; and (4) Mahaim potential at successful ablation site were present. Results Ten of twelve MAPs were clustered on the lateral walls of the mitral (n = 3, 75%) and tricuspid annuli (n = 7, 87.5%). Right‐sided MAPs were mostly long pathways extending toward the conduction system whereas left‐sided MAPs were short extending toward the neighboring myocardium. For right‐ and left‐sided APs, the median QRS times were 129 and 156 ms (p = .042), the median VAbl‐RVApex intervals were −12 and 64 ms (p = .007), the median QRS‐V(His) intervals were 16 and 86 ms (p = .120), and the median VAbl‐QRS interval was −8 and 12 ms (p = .017), respectively. Coexistence of dual atrioventricular node physiology was observed only in right‐sided APs (n = 3, 37.5%). Conclusion MAPs are more typically located on the right but may rarely be seen on the left. Catheter ablation was associated with high success without complications.
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.14852