Key result
Electrophysiological study and radiofrequency catheter ablation successfully identified and mapped a left free-wall, decrementally conducting Mahaim fiber using a discrete electrical potential.
Case Report (n=1)
This case report demonstrates the feasibility of mapping and ablating a rare left free-wall Mahaim fiber guided by direct recording of a Mahaim potential.
Supports feasibility of potential-guided ablation for rare left free-wall Mahaim fiber; extends mapping techniques but leaves open broader validation.
A 64-year-old female with Wolff-Parkinson-White syndrome and an ECG demonstrating a right posterolateral accessory pathway was referred for electrophysiological study. During electrophysiological testing two AV pathways were identified: a right posterolateral pathway that displayed conventional electrophysiological properties: and a left free-wall pathway that conducted only anterogradely and demonstrated decremental properties. Two separate wide complex tachycardias were induced that utilized the left free-wall pathway anterogradely and either the AV node or the right posterolateral accessory pathway retrogradely. A discrete electrical potential on the free wall of the mitral annulus was identified during tachycardia and was utilized to facilitate mapping and ablation.
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Johnson et al. (1997) conducted a case report in Wolff-Parkinson-White syndrome (n=1). Electrophysiological study and radiofrequency catheter ablation was evaluated on Identification and ablation of accessory pathways. Electrophysiological study and radiofrequency catheter ablation successfully identified and mapped a left free-wall, decrementally conducting Mahaim fiber using a discrete electrical potential.
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