Key result
A unified model integrates anatomic, ECG, and EP correlations to clarify para-septal accessory pathways.
Why the study?
Accurate interpretation of electrocardiographic and electrophysiologic manifestations of trans-annular accessory pathways in the right para-septal region requires a detailed understanding of para-septal anatomy and spatial relationships to the AVN-His axis.
Answers are grounded in this paper and cite their sources.
Provides a unified framework clarifying how subtle anatomic variations along the AVN-His axis account for the distinct yet overlapping ECG and EP features of para-septal accessory pathways.
Accessory pathways (APs) are classified as typical or variant according to their atrial and ventricular insertions. Typical APs connect atrial and ventricular working myocardium directly across the annulus, whereas variant APs-including the atrio-Hisian pathway (AHP), fasciculoventricular pathway (FVP), nodofascicular pathway (NFP), and nodoventricular pathway (NVP) pathways-partially or fully engage the atrioventricular node-His (AVN-His) axis. Focusing on trans-annular APs in the right para-septal region, this review emphasizes how their anatomic course and spatial relationship to the AVN-His axis determine their electrocardiographic (ECG) and electrophysiologic (EP) manifestations. Accurate interpretation of these features requires detailed understanding of para-septal anatomy. By integrating anatomic, ECG, and EP correlations, a unified schematic model is proposed to describe the relative positions, insertion sites, and conduction relationships of typical and variant APs within the right para-septal region. This framework clarifies how subtle anatomic variations along the AVN-His axis account for the distinct yet overlapping ECG and EP features of these pathways.
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Di et al. (2025) conducted a review in Para-septal accessory pathways. A unified schematic model integrating anatomic, ECG, and electrophysiologic correlations clarifies the distinct yet overlapping features of typical and variant para-septal accessory pathways.
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