Division of Cardiac ELectrophysiology, Cardiac Electrophysiology, Geisinger Heart Institute, Geisinger Commonwealth School of Medicine, Wilkes-Barre, Pennsylvania, USA.
J Cardiovasc Electrophysiol. 2021 Jun;32(6):1782-1786. doi: 10.1111/jce.15046. Epub 2021 Apr 21.
Atriofacicular pathways of Mahaim type are typically decrementally conducting accessory pathways without retrograde conduction properties, located on the right ventricular free wall at the tricuspid annulus. We report a patient with an atriofascicular pathway with minimal anterograde decremental conduction. Both long and short V-H antidromic atriofascicular reentrant tachycardias were induced and mechanism confirmed with electrophysiologic testing. Additionally, orthodromic atriofascicular reentrant tachycardia with narrow and right bundle branch block morphologies were inducible. Mahaim pathway was successfully ablated with elimination of both antidromic and orthodromic tachycardias.
Mahaim 型房室结旁路通常是位于三尖瓣环右心室游离壁的无逆向传导特性的递减传导的附加旁路。我们报告了一例具有最小顺向递减传导的房室结旁路患者。通过电生理测试诱导并证实了长、短 V-H 逆传房室结折返性心动过速的发生，并证实了其机制。此外，还可诱发窄 QRS 波群右束支阻滞形态的顺向房室结折返性心动过速。成功消融 Mahaim 旁路，消除了逆向和顺向心动过速。
