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J Am Coll Cardiol, 1988; 11:1035-1040
© 1988 by the American College of Cardiology Foundation
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"Nodoventricular" accessory pathway: evidence for a distinct accessory atrioventricular pathway with atrioventricular node-like properties

GJ Klein, GM Guiraudon, CR Kerr, AD Sharma, R Yee, T Szabo, and JA Wah

Department of Medicine, University of Western Ontario, London, Canada.

Two patients are described with recurrent pre-excited tachycardia and electrophysiologic characteristics typically ascribed to a nodoventricular accessory connection. The accessory pathway in each case demonstrated rate-dependent prolongation of conduction time and a low right ventricular insertion site; it was associated with a left bundle branch block configuration during pre-excitation. Intraoperatively, the pathway was demonstrated to originate at the anterior right atrioventricular (AV) anulus and not at the AV node. These data suggest that a "typical" nodoventricular pathway, by electrophysiologic criteria, may in fact be an AV pathway with AV node-like conduction properties and a distal right ventricular insertion site.


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Copyright © 1988 by the American College of Cardiology Foundation.