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Mahaim Revisited
Eduardo Back Sternick1, Damian Sanchez-Quintana2, Hein Jj Wellens3
1Arrhythmia and Electrophysiology Department, Biocor Institute, Nova Lima, Brazil.
Insights
Mahaim physiology is debated, with alternative pathways causing abnormal heart rhythms. This review examines the history of accessory atrioventricular junctional pathways and their role in cardiac arrhythmias.
Area of Science:
- Cardiology
- Electrophysiology
- Medical History
Background:
- The eponym "Mahaim physiology" is associated with accessory atrioventricular junctional pathways.
- Alternative anatomical substrates can cause arrhythmias misattributed to Mahaim's described pathways.
- Debate exists regarding the continued use of "Mahaim physiology" in scientific literature.
Purpose of the Study:
- To review the historical context of accessory atrioventricular junctional pathways.
- To examine the contributions of Ivan Mahaim to understanding cardiac arrhythmias.
- To discuss the ongoing debate surrounding the eponym "Mahaim physiology".
Main Methods:
- Historical literature review.
- Analysis of electrophysiological studies.
- Examination of anatomical descriptions of cardiac conduction pathways.
Main Results:
- Accessory atrioventricular junctional pathways outside the normal system can cause significant arrhythmias.
- Understanding the complex anatomy and electrophysiology of these pathways has evolved over time.
- The name Mahaim has been historically linked to discussions of these pathways, though not always accurately.
Conclusions:
- While anatomical specificity is crucial, discarding "Mahaim physiology" may not enhance understanding.
- A historical perspective on accessory atrioventricular junctional pathways is valuable.
- Further clarification on the precise role and naming of these pathways is warranted.
Abstract:
The name Ivan Mahaim is well-known to electrophysiologists. However, alternative anatomical substrates can produce the abnormal rhythms initially interpreted on the basis of the pathways he first described. These facts have prompted suggestions that Mahaim should be deprived of his eponym. It is agreed that specificity is required when describing the pathways that produce the disordered cardiac conduction, and that the identified pathways should now be described in an attitudinally appropriate fashion. The authors remain to be convinced that understanding will be enhanced simply by discarding the term 'Mahaim physiology' from the lexicon. It is fascinating to look back at the history of accessory atrioventricular junctional conduction pathways outside the normal accessory atrioventricular conduction system, and their possible role in rhythm disturbances. It took both the anatomist and the clinical arrhythmologist quite some time to understand the complex anatomical architecture and the ensuing electrophysiological properties. Over the years, the name Mahaim was often mentioned in those discussions, although these pathways were not the ones that produced the eponym. The reason for this review, therefore, is to present relevant information about the person and what followed thereafter.
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