Electrophysiological characteristics and catheter ablation left-sided accessory pathways of Mahaim fiber / 中国医师进修杂志

ABSTRACT

ObjectiveTo study electrophysiological characteristics and catheter ablation left-sided accessory pathways of Mahaim fiber.MethodsTwenty-eight patients underwent catheter ablation for Mabaim fiber and 3 patients was left-sided accessory pathways.All of them were male with 34,20,38 years old.The tachycardia history was1-5years. Electrophysiological characteristics,target sitesand electrocardiogram(ECG,12 leads) were recorded through catheter from coronary sinus(CS),high right atrium(HRA),His bundle and ablation.ResultsOne patient's ECG showed little preexcitation,the other two were normal. Atrial stimulation could be easily induced tachycardia.Their ECG showed wide QRS waves (right bundle branch block or similar right bundle branch block).The characteristics of accessory pathways were slow and anterograde decremental conduction as well as blocked by adenosine triphosphate injection.Ventricular-atrial conduction was via atrioventricular node with centripetal decreasing transmission during ventricular pacing.During tachycardia,the His bundle electrogram resulted in a V-H-A pattern,the retrograde A in His bundle was pioneer.The atriofascicular pathways of 2 patients were completely ablated respectively in left posterior lateral and before the free wall of mitral valve ring.The nodoventricular pathway of 1 patient was successfully ablated in left middle posterior lateral of mitral valve ring.ConclusionsThe left-sided accessory pathways of Mahaim fiber is an uncommon accessory pathway,which has specific electrophysiological characteristics.It is effective and safe to ablate accessory pathway with radiofrequency.