Left posteroseptal Mahaim fiber associated with marked longitudinal dissociation

Pacing Clin Electrophysiol. 1999 Nov;22(11):1696-9. doi: 10.1111/j.1540-8159.1999.tb00393.x.

Abstract

We report a patient who underwent radiofrequency catheter ablation of a left posteroseptal atrioventricular (AV) Mahaim fiber with a marked longitudinal dissociation. During atrial pacing, Wenckebach-type atrioventricular block over the accessory pathway was observed with progressive preexcitation and no change in polarity of the delta waves. The AV conduction curve was discontinuous, with a distinct "jump-up" in local AV conduction time of 84 ms. The earliest ventricular activation was recorded from the posteroseptal portion of the mitral annulus, and the unipolar electrogram from a distal electrode had a high, steep deflection with uniphasic QS-like activity with 62 ms of local AV conduction time.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bundle of His / physiopathology
  • Bundle of His / surgery
  • Cardiac Pacing, Artificial
  • Catheter Ablation
  • Electrocardiography*
  • Heart Atria / physiopathology
  • Heart Ventricles / physiopathology
  • Humans
  • Male
  • Pre-Excitation, Mahaim-Type / diagnosis*
  • Pre-Excitation, Mahaim-Type / physiopathology
  • Pre-Excitation, Mahaim-Type / surgery