Key result
His bundle recordings identify rare ectopic beats arising within Kent and Mahaim accessory pathways.
Why the study?
Specialized electrophysiological studies are essential to diagnose unusual arrhythmias arising from accessory atrioventricular tracts such as Kent and Mahaim tracts.
Case Report (n=2)
His bundle recordings are useful for diagnosing complex arrhythmias originating from accessory pathways like Kent and Mahaim tracts.
His bundle recordings may aid diagnosis of rare accessory pathway ectopy; leaves open generalizability pending larger validation.
His bundle electrograms were recorded in 2 patients with ectopic beats arising in accessory atrioventricular tracts. Case 1 had Wolff-Parkinson-White (WPW) type A and a left-sided Kent tract with a short effective refractory period. Though ectopic impulse formation most probably occurred within the Kent tract itself, a vulnerability-related origin in the ventricular muscle close to the distal end of the Kent tract could not be excluded. In Case 2, with a Mahaim tract extending from His bundle to ventricles, there were three types of QRS morphologies resulting from : (a) atrioventricular conduction exclusively through the normal pathways; (b) atrioventricular conduction through both, normal pathway, and Mahaim tract; and (c) ectopic impulse formation in the Mahim tract. Specialized electrophysiological studies were essential to diagnose these unusual arrhythmias.
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Castellanos et al. (1976) conducted a case report in Ectopic beats arising in accessory atrioventricular tracts (n=2). His bundle recordings was evaluated on Diagnosis of impulse formation. His bundle recordings were essential to diagnose unusual arrhythmias in 2 patients with ectopic beats arising in Kent and Mahaim tracts.
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