Dual conduction in a Mahaim fiber

J Cardiovasc Electrophysiol. 2004 Oct;15(10):1212-5. doi: 10.1046/j.1540-8167.2004.04036.x.

Abstract

The case of an 8-year-old girl with incessant nonsustained left bundle branch block-like tachycardia refractory to antiarrhythmic drug therapy is reported. Electrophysiologic study revealed the presence of a right-sided accessory atriofascicular pathway. Episodes of nonsustained tachycardia were found to be based upon a dual response in AV conduction over the Mahaim fiber to one P wave. No reentrant tachycardia could be induced. The arrhythmia was cured by catheter ablation targeting a Mahaim potential at the right lateral tricuspid annulus. The findings can be explained by longitudinal dissociation in a single Mahaim fiber, a fiber distally diverging into two fibers with different conduction times, or (less likely) two closely located Mahaim fibers with different conduction times.

Publication types

  • Case Reports

MeSH terms

  • Bundle-Branch Block / etiology
  • Child
  • Electrocardiography
  • Female
  • Heart Conduction System / abnormalities*
  • Humans
  • Tachycardia / etiology*