Key result
Catheter ablation targeting a Mahaim potential at the right lateral tricuspid annulus successfully cured incessant nonsustained tachycardia caused by dual AV conduction over a Mahaim fiber.
Case Report (n=1)
Catheter ablation targeting a Mahaim potential successfully cured incessant nonsustained LBBB-like tachycardia caused by dual conduction over a Mahaim fiber in a pediatric patient.
May guide ablation targeting in rare Mahaim cases; leaves open need for prospective data on durability and safety.
The case of an 8-year-old girl with incessant nonsustained left bundle branch block-like tachycardia refractory to antiarrhythmic drug therapy is reported. Electrophysiologic study revealed the presence of a right-sided accessory atriofascicular pathway. Episodes of nonsustained tachycardia were found to be based upon a dual response in AV conduction over the Mahaim fiber to one P wave. No reentrant tachycardia could be induced. The arrhythmia was cured by catheter ablation targeting a Mahaim potential at the right lateral tricuspid annulus. The findings can be explained by longitudinal dissociation in a single Mahaim fiber, a fiber distally diverging into two fibers with different conduction times, or (less likely) two closely located Mahaim fibers with different conduction times.
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Sternick et al. (2004) conducted a case report in Incessant nonsustained left bundle branch block-like tachycardia (n=1). Catheter ablation targeting a Mahaim potential at the right lateral tricuspid annulus was evaluated on Cure of arrhythmia. Catheter ablation targeting a Mahaim potential at the right lateral tricuspid annulus successfully cured incessant nonsustained tachycardia caused by dual AV conduction over a Mahaim fiber.
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