Nodoventricular Mahaim fibers are associated with sustained reentrant tachycardia with LBBB morphology, while fasciculoventricular fibers do not show a direct relationship to observed arrhythmias.
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Nodoventricular fibers may participate in LBBB reentry; case reports leave open prevalence, mapping targets, and need for larger studies.
Twelve patients with evidence of Mahaim fibers are reported, six with nodoventricular (NV) fibers and six with fasciculoventricular (FV) fibers. All patients with NV fibers had left bundle branch block morphology, and a sustained reentrant tachycardia with this morphology was proved in each case. In three of the six, ventriculoatrial dissociation occurred during tachycardia. We postulate that the mechanism of this tachycardia is a macroreentry circuit using the NV fiber for the antegrade limb and the His-Purkinje system with a portion of the atrioventricular node for the retrograde limb. ECGs of patients with FV fibers were varied, suggesting a functional relation to the right or left side of the septum. No direct relationship of FV fibers to observed arrhythmias could be found.
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Gallagher et al. (1981) studied this question.
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