Sternick Eduardo Back, Gerken Luiz Márcio, Vrandecic Mário
Biocor Instituto, Nova Lima, Brazil.
J Cardiovasc Electrophysiol. 2002 Mar;13(3):244-9. doi: 10.1046/j.1540-8167.2002.00244.x.
A series of four patients with right-sided accessory pathways with long conducting times and decremental properties is reported. All patients underwent radiofrequency catheter ablation, and target areas were guided by a discrete "Mahaim" potential recorded at the lateral aspect of the tricuspid valve. A slow automatic and irregular rhythm with a QRS morphology similar to that of a fully preexcited QRS complex occurred during radiofrequency current delivery. The occurrence of so-called "Mahaim" automatic tachycardia heralded successful elimination of the accessory pathway in a manner similar to that of junctional automatic rhythm during slow pathway ablation in patients with AV nodal reentrant tachycardia. The observation of an automatic rhythm brought about during radiofrequency current ablation of a Mahaim-like accessory pathway is electrophysiologic evidence of the accessory AV nodal behavior of this structure.
报告了一系列4例右侧旁路传导时间长且具有递减特性的患者。所有患者均接受了射频导管消融术，目标区域由在三尖瓣外侧记录到的离散“Mahaim”电位引导。在射频电流输送期间出现了一种缓慢的自动且不规则的节律，其QRS形态类似于完全预激的QRS波群。所谓“Mahaim”自动性心动过速的出现预示着旁路成功消除，其方式类似于房室结折返性心动过速患者在慢径路消融期间出现的交界性自动节律。在类似Mahaim旁路的射频电流消融期间观察到自动节律，是该结构房室结旁道行为的电生理证据。
