Key result
An electrophysiological study demonstrated that the patient's narrow QRS complex tachycardia with atrioventricular dissociation was caused by a circuit involving nodoventricular Mahaim fibers.
Case Report (n=1)
This case demonstrates that narrow QRS complex tachycardia with atrioventricular dissociation can be caused by a circuit involving antegrade conduction via the AV nodo-His axis and retrograde conduction via a nodoventricular bypass tract (Mahaim fibers).
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May warrant consideration of nodoventricular pathways in refractory narrow QRS tachycardia with AV dissociation; hypothesis-generating from Level 5 evidence.
We describe the case of a 22-year-old man who had frequent episodes of narrow QRS complex tachycardia with atrioventricular dissociation. The ECG during sinus rhythm showed normal PR and QRS intervals, but it showed a left bundle branch block configuration during atrial pacing or after injection of verapamil. An electrophysiological study demonstrated that the patient had nodoventricular Mahaim fibers. The narrow QRS complex tachycardia was explained by a circuit involving antegrade conduction via the atrioventricular nodo-His axis and retrograde conduction via the nodoventricular bypass tract.
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Shimizu et al. (1988) conducted a case report in Narrow QRS complex tachycardia with atrioventricular dissociation (n=1). Electrophysiological study was evaluated on Electrophysiological mechanism of tachycardia. An electrophysiological study demonstrated that the patient's narrow QRS complex tachycardia with atrioventricular dissociation was caused by a circuit involving nodoventricular Mahaim fibers.
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