Radiofrequency ablation of a concealed nodoventricular Mahaim fiber guided by a discrete potential
Abstract
INTRODUCTION: We present the case of a 17-year-old woman who underwent an electrophysiological study and radiofrequency (RF) ablation of supraventricular tachycardia refractory to medical treatment. Two right-sided, concealed, nondecremental atrioventricular accessory pathways (AV-APs) involved in orthodromic circus movement tachycardias were identified. After RF ablation of both AV-APs, evidence of bidirectional dual AV nodal conduction was demonstrated and regular narrow complex tachycardia was induced. METHODS AND RESULTS: During the tachycardia, retrograde slow and fast AV nodal pathway conduction with second-degree ventriculoatrial (VA) block and VA dissociation were observed. During the tachycardia with second-degree VA block, ventricular extrastimuli elicited during His-bundle refractoriness advanced the next His potential or terminated the tachycardia. Mapping the right atrial mid-septal region, a distinct high-frequency activation P potential was recorded in a discrete area, two thirds of the way from the His bundle toward the os of the coronary sinus. Detailed electrophysiologic testing with the recordable P potential demonstrated that the tachycardia utilized a concealed nodoventricular AP arising from the proximal slow AV nodal pathway. CONCLUSION: The tachycardia with slow 1:1 VA conduction could be reset by ventricular extrastimuli elicited during His-bundle refractoriness advancing the subsequent activation P potential and atrial activation. RF ablation guided by recording of the activation P potential resulted in elimination of both the slow AV nodal pathway and the nodoventricular connection with preservation of the normal AV conduction system.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Mahaim conduction is usually antegrade only, but concealed fibres have also been described.
“Mahaim conduction is usually antegrade only, but concealed fibres have also been described.332”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [332]
Cites
Role of Mahaim fibers in cardiac arrhythmias in man.
Gallagher, J. J., Smith, W., Kasell, J. H., et al. (1981) · Circulation · doi:10.1161/01.cir.64.1.176 · Cited by 291 · see citing works
McClelland, J. H., Wang, X., Beckman, K. J., Hazlitt, H. A., PRIOR, M. I., Nakagawa, H., Lazzara, R., & Jackman, W. M. (1994) · Circulation · doi:10.1161/01.cir.89.6.2655 · Cited by 212 · see citing works
Klein, G. J., Guiraudon, G. M., Kerr, C. R., Sharma, A. D., Yee, R., Szabo, T. S., & Yeung‐Lai‐Wah, J. A. (1988) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)90063-8 · Cited by 200 · see citing works
Haı̈ssaguerre, M., Cauchemez, B., Marcus, F., Le Métayer, P., Lauribe, P., Poquet, F., Gencel, L., & Clémenty, J. (1995) · Circulation · doi:10.1161/01.cir.91.4.1077 · Cited by 146 · see citing works
Radiofrequency catheter ablation of Mahaim fibers at the tricuspid annulus.
Klein, L. S., Hackett, F. K., Zipes, D. P., & Miles, W. M. (1993) · Circulation · doi:10.1161/01.cir.87.3.738 · Cited by 102 · see citing works
KOTTKAMP, H., HINDRICKS, G., SHENASA, H., CHEN, X., WICHTER, T., BORGGREFE, M., & BREITHARDT, G. (1996) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1996.tb00466.x · Cited by 91 · see citing works
Cappato, R., Schlüter, M., Weiss, C., et al. (1994) · Circulation · doi:10.1161/01.cir.90.1.282 · Cited by 89 · see citing works
Radiofrequency catheter ablation of atriofascicular and nodoventricular Mahaim tracts.
Grogin, H. R., Lee, R. J., Kwasman, M. A., et al. (1994) · Circulation · doi:10.1161/01.cir.90.1.272 · Cited by 88 · see citing works
Involvement of a Nodofascicular Connection in Supraventricular Tachycardia with VA Dissociation
Haı̈ssaguerre, M., CAMPOS, J., Marcus, G. M., et al. (1994) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1994.tb01124.x · Cited by 52 · see citing works
Mechanism of tachycardia using a nodofascicular mahaim fiber
Bardy, G. H., German, L. D., Packer, D. L., Coltorti, F., & Gallagher, J. J. (1984) · The American Journal of Cardiology · doi:10.1016/s0002-9149(84)80163-0 · Cited by 51 · see citing works
Coexistent mahaim and kent accessory connections: Diagnostic and therapeutic implications
Abbott, J. A., Scheinman, M. M., Morady, F., et al. (1987) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(87)80020-7 · Cited by 51 · see citing works
Okishige, K., & Friedman, P. L. (1995) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1995.tb04739.x · Cited by 44 · see citing works
Brugada, J., Martı́nez, J. A., Kuzmicic, B., et al. (1995) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1995.tb02600.x · Cited by 35 · see citing works
Narrow QRS Complex Tachycardia with Atrioventricular Dissociation
Shimizu, A., Ohe, T., Takaki, H., et al. (1988) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1988.tb05997.x · Cited by 31 · see citing works
Nodoventricular Mahaim fiber connecting to the left ventricle
Yamabe, H., Okumura, K., Minoda, K., et al. (1991) · American Heart Journal · doi:10.1016/0002-8703(91)90784-f · Cited by 29 · see citing works
Participation of a concealed nodoventricular fiber in the genesis of paroxysmal tachycardias
Wu, D., Yeh, S., YAMAMOTO, T., et al. (1990) · American Heart Journal · doi:10.1016/s0002-8703(05)80281-9 · Cited by 21 · see citing works
Radiofrequency Ablation of a Mahaim Fiber Following Localization of Mahaim Pathway Potentials
Mounsey, J. P., GRIFFITH, M. J., & McComb, J. M. (1994) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1994.tb01182.x · Cited by 20 · see citing works
Hluchý, J., Wieczorek, M., Tekiyeh, M., et al. (1996) · Clinical Cardiology · doi:10.1002/clc.4960190915 · Cited by 13 · see citing works
Radiofrequency ablation of decremental accessory pathways mimicking “nodoventricular” conduction
LI, H. G., Klein, G. J., Thakur, R. K., et al. (1994) · The American Journal of Cardiology · doi:10.1016/0002-9149(94)90449-9 · Cited by 12 · see citing works
Multiple reentry tachycardia in patients with ventricular preexcitation: Report of three cases
Murabit, I., Sosa, E., Pileggi, F. J. C., et al. (1986) · American Heart Journal · doi:10.1016/0002-8703(86)90555-7 · Cited by 12 · see citing works
Successful radiofrequency ablation in reentrant tachycardia incorporating a nodoventricular tract
Wen, M., Yeh, S., Wang, C., et al. (1994) · American Heart Journal · doi:10.1016/0002-8703(94)90066-3 · Cited by 6 · see citing works
Deng, Z., Gang, E. S., ROSENTHAL, M. E., et al. (1986) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1986.tb05391.x · Cited by 5 · see citing works
Li, H., Yee, R. K., Thakur, R. K., et al. (1997) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1997.tb04230.x · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Katritsis, D. G., Boriani, G., Cosio, F. G., Hindricks, G., Jaïs, P., Josephson, M. E., Keegan, R., Kim, Y.-H., Knight, B. P., Kuck, K.-H., et al. (2017) · Europace · doi:10.1093/europace/euw301 · Cited by 188 · see citing works
- Authors
- HLUCHY, J., SCHLEGELMILCH, P., SCHICKEL, S., JÖRGER, U., JURKOVICOVA, O., & SABIN, G. V.
- Venue
- Journal of Cardiovascular Electrophysiology
- Publisher
- Wiley
- Published
- 1999-04
- Volume
- 10
- Issue
- 4
- Pages
- 603-610
- ISSN
- 1045-3873 (ISSN-L)
- 1540-8167
- OpenAlex
- W2013528144
- Cited by
- 28
- References
- 23
- Citations by year
- 2026: 1 · 2022: 4 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 1 · 2012: 1
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiovascular Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- radiofrequency ablation, supraventricular tachycardia, accessory pathway, ventriculoatrial block, adolescent patient
- MeSH terms
- Adolescent, Bundle of His, Electrocardiography, Female, Humans, Tachycardia, Supraventricular, Wolff-Parkinson-White Syndrome, Catheter Ablation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
