Uncovering a unique path: Antidromic AVRT utilizing a left anteroseptal Mahaim-like accessory pathway
Amneet Sandhu1,2, Wendy S Tzou1, Ryan T Borne1
1Section of Electrophysiology, The University of Colorado, Aurora, Colorado.
Abstract:
A 40-year-old man presented to our emergency department 2 hours after onset of shortness of breath, palpitations, and presyncope secondary to an adenosine-responsive wide complex tachycardia. Electrophysiology study was diagnostic for antidromic atrioventricular (AV) reentrant tachycardia utilizing a muscular connection from the anterior interventricular vein to the left ventricle with Mahaim-like properties, successfully treated with ablation in the distal coronary sinus (CS) system. This case highlights accessory pathways (a) with unique features (i.e., Mahaim-like characteristics) and (b) involving musculature from the distal CS system, thereby limiting the value of endocardial ablation for durable treatment. Importantly, the coronary venous system is an accessible vascular network for evaluation and catheter ablation of such arrhythmias.
More Related Videos
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
09:13Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures
Published on: April 21, 2013
Related Concept Videos
Conduction System of the Heart
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...
Conduction System of the Heart
This system relies on the unique properties of nodal and Purkinje cells:...
Mechanism of Cardiac Arrhythmias
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Dysrhythmias II: Classification of Tachyarrhythmias
Dysrhythmias IV: Characteristics of Bradyarrhythmias
