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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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2004-10, Vol.15 (10), p.1212-1215
Main Authors: STERNICK, EDUARDO BACK, SOSA, EDUARDO A., SCANAVACCA, MAURÍCIO I., WELLENS, HEIN J.J.
Format: Article
Language:English
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.
ISSN:1045-3873
1540-8167
DOI:10.1046/j.1540-8167.2004.04036.x