Key Points
- To characterize the electrophysiological mechanisms and surgical management of concurrent Kent bundle and Mahaim-type accessory pathways in a patient with pre-excitation syndrome.
- Evaluated a single patient presenting with Ebstein's anomaly of the tricuspid valve and Wolff-Parkinson-White syndrome.
- Utilized intracardiac catheter techniques alongside intraoperative epicardial mapping to identify accessory conduction routes.
- Performed surgical transection of the accessory Kent pathway.
- Demonstrated dual ventricular pre-excitation mediated simultaneously by a right posterior Kent bundle and atrioventricular node-to-right ventricle Mahaim fibers.
- Identified two distinct forms of supraventricular tachycardia caused by re-entry involving antegrade conduction through normal or Mahaim paths and retrograde conduction via the Kent bundle.
- Surgical division of the Kent bundle successfully abolished all clinically debilitating tachyarrhythmias.
Structured PICO
PPopulation1 patient with Ebstein's anomaly of the tricuspid valve and Wolff-Parkinson-White syndrome
IInterventionSurgical division of the Kent bundle
OOutcomeAbolition of clinically debilitating arrhythmias
Demonstrates the successful surgical treatment of complex pre-excitation involving both Kent and Mahaim tracts in a patient with Ebstein's anomaly.