Key result
Intracardiac EPS reveals unusual coexistence of functional Mahaim and accessory AV pathways in WPW syndrome.
Case Report (n=2)
This case series provides the first electrophysiologic demonstration of triple accessory pathways in a patient with Wolff-Parkinson-White syndrome.
Alerts to multiple pathways in WPW wide-QRS tachycardia; hypothesis-generating case report leaves open prevalence and therapy implications.
In two patients with Wolff-Parkinson-White syndrome, we observed the unusual coexistence of functional Mahaim and accessory atrioventricular pathways. In the first patient, three types of reciprocating tachycardia were demonstrable: (1) anterograde conduction over the atrioventricular (AV) node with right bundle branch block (RBBB) and retrograde conduction via a right-sided atrioventricular accessory pathway; (2) anterograde conduction through the AV node with RBBB and retrograde conduction via two (right-sided and septal) anomalous pathways; and (3) anterograde conduction through nodoventricular fibers and retrograde conduction over a right-sided accessory pathway. In the second patient the reentry circuit was comprised of AV node fasciculoventricular fiber in an anterograde direction and a right-sided accessory pathway in a retrograde direction. We believe this to be the first report of triple accessory pathways, consisting of two atrioventricular and one nodoventricular connection, demonstrated by intracardiac electrophysiologic study.
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Sethi et al. (1985) conducted a case report in Wolff-Parkinson-White syndrome (n=2). Intracardiac electrophysiologic study was evaluated on Demonstration of coexisting functional Mahaim and accessory atrioventricular pathways. Intracardiac electrophysiologic study demonstrated the unusual coexistence of functional Mahaim and accessory atrioventricular pathways in two patients with Wolff-Parkinson-White syndrome.
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