Comprehensive assessment of Mahaim accessory pathways' anatomic distribution

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Arrhythmias

Background:

• Mahaim-type accessory pathways (MAPs) are a type of cardiac accessory pathway that can cause arrhythmias.
• Understanding the precise anatomic localization of MAPs is crucial for successful ablation.

Purpose of the Study:

• To describe the experience with Mahaim-type accessory pathways (MAPs).
• To focus on the anatomic localizations of MAPs during ablation procedures.
• To evaluate the success rate of MAP ablation.

Main Methods:

• Retrospective analysis of data from 55 consecutive patients undergoing electrophysiological study (EPS) for MAP ablation.
• Data collected from two tertiary centers between January 1998 and June 2020.
• Focus on ablation sites including tricuspid annulus, mitral annulus, paraseptal region, and right ventricle.

Main Results:

• MAPs were most frequently ablated at the tricuspid annulus (78.2%).
• Other locations included the mitral annulus (7.3%), paraseptal region (5.5%), and right ventricle (9.1%).
• The success rate for ablation therapy in 49 patients was high at 91.8%.

Conclusions:

• Mahaim-type accessory pathways (MAPs) demonstrate varied anatomic distributions, with a predilection for the tricuspid annulus.
• The M potential mapping technique shows promise as a target for effective MAP ablation.
• Successful ablation rates underscore the efficacy of current electrophysiological strategies for MAPs.