Coexistence of Functional Kent and Mahaim-type
نویسندگان
چکیده
An unusual patient with Ebstein's anomaly of the tricuspid valve and the Wolff-Parkinson-White syndrome is presented. Ventricular pre-excitation related to conduction over both a right posterior Kent bundle and Mahaim fibers coursing from the atrioventricular node to the right ventricle. Two types of supraventricular tachycardia were demonstrable. These were due to re-entry involving antegrade conduction over either the normal or Mahaim paths, and retrograde conduction via the Kent bundle. Surgical division of the Kent bundle has abolished the clinically debilitating arrhythmias.
منابع مشابه
His bundle recordings in diagnosis of impulse formation in Kent and Mahaim tracts.
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 e...
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The atriofascicular accessory pathway (AP), known as the Mahaim pathway, is a rare form of pre-excitation, comprising less than 3% of all APs. Mahaim AP is characterized by decremental, anterograde-only conduction, and antidromic tachycardia with left bundle branch morphology. Prevalence of Mahaim AP in Ebstein's anomaly is significantly high. In addition, combination of Wolff-Parkinson-White (...
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His bundle electrograms were recorded in a patient with pre-excitation and normal PR intervals to determine whether conduction was via anomalous A-V connection (Kent bundle) or infranodal bypass (Mahaim tract). During sinus rhythm (62/ min) both P-delta and P-H measured 155 msec. With atrial pacing at 70 and 75/min, P-H prolonged while P-delta remained constant. At 80/min, the anomalous pathway...
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